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Minamida M, Okada H, Hamaguchi M, Hironaka J, Kondo Y, Nakajima H, Okamura T, Sennmaru T, Nakanishi N, Ushigome E, Fukui M. Association between gastrointestinal symptoms and insomnia in patients with type 2 diabetes: The KAMOGAWA-DM cohort study. J Diabetes Investig 2024; 15:946-952. [PMID: 38444280 PMCID: PMC11215685 DOI: 10.1111/jdi.14168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/04/2024] [Accepted: 02/10/2024] [Indexed: 03/07/2024] Open
Abstract
AIMS/INTRODUCTION Gastrointestinal disturbances and insomnia affect the quality of life of patients with diabetes. However, the relationship between gastrointestinal symptoms and insomnia in patients with diabetes has rarely been analyzed. Thus, aim of this study was to investigate the association between gastrointestinal symptoms and insomnia in patients with type 2 diabetes mellitus. MATERIALS AND METHODS This cross-sectional study of patients with type 2 diabetes was carried out from January 2014 to April 2022 using the database of the KAMOGAWA-DM cohort study. Patient data were collected using a self-administered questionnaire, and the Izumo Scale and the Athens Insomnia Scale were used to assess gastrointestinal symptoms and insomnia, respectively. Multivariate logistic regression analysis was carried out to determine the association between gastrointestinal symptoms and insomnia. RESULTS A total of 175 patients with type 2 diabetes were included in this study. Patients with insomnia had higher Izumo scores than those without insomnia (P < 0.0001). Izumo scale score was significantly associated with insomnia in patients with type 2 diabetes, even after adjustment for age, body mass index, systolic blood pressure, glycated hemoglobin level, neuropathy, insulin therapy and nocturia (odds ratio 1.10, 95% confidence interval [CI] 1.06-1.16). Each gastrointestinal symptom assessed using the Izumo scale was associated with insomnia. The odds ratios of heartburn, stomach pain, lethargy, constipation and diarrhea for insomnia were 1.32 (95% CI 1.13-1.55), 1.38 (95% CI 1.16-1.63), 1.33 (95% CI 1.13-1.56), 1.21 (95% CI 1.08-1.36) and 1.29 (95% CI 1.12-1.47), respectively. CONCLUSIONS Gastrointestinal symptoms are strongly associated with sleep disturbances in patients with type 2 diabetes.
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Affiliation(s)
- Megumi Minamida
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Hiroshi Okada
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Masahide Hamaguchi
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Junya Hironaka
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Yuriko Kondo
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Hanako Nakajima
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Takuro Okamura
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Takafumi Sennmaru
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Naoko Nakanishi
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Emi Ushigome
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
| | - Michiaki Fukui
- Department of Endocrinology and MetabolismKyoto Prefectural University of Medicine, Graduate School of Medical ScienceKyotoJapan
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Tutan D, Erdoğan Kaya A, Kayaalp M. Sodium-Glucose Co-transporter Type-2 Inhibitors' Effect on Quality of Life in Older Adult Population. Cureus 2023; 15:e47005. [PMID: 37841994 PMCID: PMC10576159 DOI: 10.7759/cureus.47005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction The global elderly population is expanding, with chronic conditions like diabetes diminishing their quality of life. Sodium-glucose co-transporter type 2 (SGLT-2) inhibitors hold promise in improving quality of life by addressing hypervolemia, obesity, and lipid irregularities. However, these drugs can lead to adverse effects, such as polyuria, dehydration, and weight loss, which may detrimentally impact older patients. We aimed to investigate the association between SGLT-2 inhibitors and quality of life in older adults with diabetes. Methods The research included 100 type II diabetes mellitus patients over 65, without active infections, malignancies, immunodeficiencies, and hematological disorders. Fifty patients were using empagliflozin or dapagliflozin and 50 patients were using other oral antidiabetics for at least six months. Patient demographics, laboratory studies, drug usage and side effects, additional diseases, Geriatric Depression Scale scores, and World Health Organization Quality of Life OLD (WHOQoL-OLD) module scores were noted. Results No significant difference between gender distribution, SGLT usage, chronic disease existence, chronic disease count, depression scores, or incidents of chronic diseases other than hyperlipidemia was observed. Hyperlipidemia incidence was significantly higher in the SGLT group, while other laboratory parameters were not statistically significantly different between groups. There were no significant differences in autonomy, past-present-future activities, social skills, death, intimacy, and total WHOQoL-OLD scores between the two groups. However, there were statistically significantly worse outcomes in patients with at least one SGLT adverse effect in terms of sensory quality of life scores. Dehydration existence was negatively correlated with lower autonomy, PPF activities, and total quality of life scores. Multivariate linear regression analysis showed no significant differences in the total WHOQoL-OLD score after adjusting for confounding factors. Conclusion Age and depression remained the main factors affecting the quality of life in diabetic patients. SGLT-2 inhibitor side effects did not decrease the quality of life in older individuals, who are more prone to unfavorable consequences.
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Affiliation(s)
- Duygu Tutan
- Department of Internal Medicine, Erol Olçok Training and Research Hospital, Çorum, TUR
| | - Ayşe Erdoğan Kaya
- Department of Psychiatry, Erol Olçok Training and Research Hospital, Çorum, TUR
| | - Mehmet Kayaalp
- Department of Internal Medicine, Erol Olçok Training and Research Hospital, Çorum, TUR
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Choi GW, Chang SJ. Correlation of health-related quality of life for older adults with diabetes mellitus in South Korea: theoretical approach. BMC Geriatr 2023; 23:491. [PMID: 37580707 PMCID: PMC10426193 DOI: 10.1186/s12877-023-04186-5] [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: 03/02/2023] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND While some studies have explored the health-related quality of life (HRQOL) of older adults with diabetes mellitus (DM) in South Korea using a theoretical framework, these studies suffer sample-related limitations, as they focus only on a specific subgroup of older adults. To address this gap, this study aimed to investigate the predictors of HRQOL of older adults with DM in South Korea, using extensive national data and based on the theory of Health-Related Quality of Life in South Korean Older Adults with Type 2 Diabetes (The HIKOD theory). METHODS A secondary data analysis was conducted using data from 1,593 participants aged 65 years and older with DM sourced from the 2015-2019 Korea National Health and Nutrition Examination Survey (KNHANES). The variables included in this study are as follows: demographic factors (gender, age, household income, and education level), disease-specific factors (duration of DM, treatment of DM, and control of HbA1c), barriers (number of comorbidities), resources (living alone status), psychosocial factors (perceived stress), and health-promoting behaviors (physical activity and fundus examination). Considering the complex sampling design employed in this study, statistical analyses including Rao-Scott chi-square tests, correlation analysis, and hierarchical multiple regression analysis were conducted. RESULTS Mobility (45.0%) was the HRQOL dimension with which participants experienced the highest number of problems. Number of comorbidities (r = -0.36, p < 0.001), living alone status (rpb = 0.16, p < 0.001), perceived stress (rpb = 0.14, p < 0.001), and physical activity (rpb = 0.12, p < 0.001) were correlated with HRQOL. While adjusting for background factors, HRQOL was negatively predicted by higher number of comorbidities (estimate B = -0.03, p < 0.001), living alone (estimate B = -0.03, p = 0.043), higher perceived stress (estimate B = -0.09, p < 0.001), and lower physical activity (estimate B = -0.03, p < 0.001). CONCLUSION Complex and diverse factors influence HRQOL among older adults with DM in South Korea. To improve their HRQOL, intervention programs that integrally regard HRQOL, along with various predictors, are necessary.
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Affiliation(s)
- Gi Won Choi
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea (BK21) four project, College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sun Ju Chang
- College of Nursing and The Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Liu CK, Miao S, Giffuni J, Katzel LI, Fielding RA, Seliger SL, Weiner DE. Geriatric Syndromes and Health-Related Quality of Life in Older Adults with Chronic Kidney Disease. KIDNEY360 2023; 4:e457-e465. [PMID: 36790849 PMCID: PMC10278840 DOI: 10.34067/kid.0000000000000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023]
Abstract
Key Points In older adults with CKD, geriatric syndromes are common and are associated with reduced quality of life. Addressing geriatric syndromes could potentially improve quality of life for older adults with CKD. Background Geriatric syndromes, which are multifactorial conditions common in older adults, predict health-related quality of life (HRQOL). Although CKD is associated with lower HRQOL, whether geriatric syndromes contribute to HRQOL in CKD is unknown. Our objective was to compare associations of geriatric syndromes and medical conditions with HRQOL in older adults with CKD. Methods This was a secondary analysis of a parallel-group randomized controlled clinical trial evaluating a 12-month exercise intervention in persons 55 years or older with CKD stage 3b–4. Participants were assessed for baseline geriatric syndromes (cognitive impairment, poor appetite, dizziness, fatigue, and chronic pain) and medical conditions (diabetes, hypertension, coronary artery disease, cancer, or chronic obstructive pulmonary disease). Participants' HRQOL was assessed with the Short Form Health Survey-36 (SF-36), EuroQol 5-Dimensions 5-Level, and the EuroQol Visual Analogue Scale. We examined the cross-sectional and longitudinal associations of geriatric syndromes and medical conditions with HRQOL using multiple linear regression. Results Among 99 participants, the mean age was 68.0 years, 25% were female, and 62% were Black. Participants had a baseline mean of 2.0 geriatric syndromes and 2.1 medical conditions; 49% had ≥ two geriatric syndromes and ≥ two medical conditions concurrently. Sixty-seven (68%) participants underwent 12-month assessments. In models using geriatric syndromes and medical conditions as concurrent exposures, the number of geriatric syndromes was cross-sectionally associated with SF-36 scores for general health (β =−0.385) and role limitations because of physical health (β =−0.374) and physical functioning (β =−0.300, all P <0.05). The number of medical conditions was only associated with SF-36 score for role limitations because of physical health (β =−0.205). Conclusions In older adults with CKD stage 3b–4, geriatric syndromes are common and are associated with lower HRQOL. Addressing geriatric conditions is a potential approach to improve HRQOL for older adults with CKD. Clinical Trial registry name and registration number: NCT01462097 ; Registration Date–October 26, 2011.
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Affiliation(s)
- Christine K. Liu
- Section of Geriatric Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
- Geriatric Research and Education Clinical Center, Veteran Affairs Palo Alto Health Care System, Palo Alto, California
- Nutrition Exercise Physiology and Sarcopenia Team, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Shiyuan Miao
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Jamie Giffuni
- Geriatric Research Education and Clinical Center, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland
| | - Leslie I. Katzel
- Geriatric Research Education and Clinical Center, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland
- Division of Gerontology, Geriatrics, and Palliative Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Roger A. Fielding
- Nutrition Exercise Physiology and Sarcopenia Team, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Stephen L. Seliger
- Geriatric Research Education and Clinical Center, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland
- Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Daniel E. Weiner
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
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Araki A, Umegaki H, Sakurai T, Mizuno Y, Miyao M, Imori M, Suzuki S, Cambron-Mellott MJ, Yokote K, Onuma T, Yokono K. Determinants and impact of physical impairment in patient-reported outcomes among older patients with type 2 diabetes mellitus in Japan. Curr Med Res Opin 2021; 37:393-402. [PMID: 33140980 DOI: 10.1080/03007995.2020.1846170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the predictive factors associated with physical impairment among older patients with type 2 diabetes mellitus (T2DM) in Japan and to examine the potential impact of physical impairment on patient-reported health outcomes in this population. METHODS A cross-sectional analysis was conducted using patient-reported data from the 2012-2014 Japan National Health and Wellness Survey. Physical impairment was measured using the Physical Component Summary (PCS) score of the Short-Form 36-Item Health Survey (SF-36) three-component model (using Japanese norms). Older T2DM patients (≥65 years old; n = 1511) were dichotomized into physically impaired (PCS ≤ 25th percentile; n = 378) and non-physically impaired (PCS > 25th percentile; n = 1133). Work productivity (absenteeism, presenteeism and overall work impairment), activity impairment and healthcare resource utilization were compared between these groups. RESULTS Age, female sex, low and high body mass index (BMI), diabetes-related complications, cardiovascular events, unawareness of having hypoglycemic events in the past 3 months, and lack of regular exercise were significant factors associated with physical impairment in multivariable analysis. The physically impaired group reported significantly more regular outpatient visits (13.48 vs. 10.16, respectively, p < .001), 1% or greater absenteeism (16.7% vs. 4.1%, p = .005), greater presenteeism (27.8% vs. 12.2%, p = .001), overall work impairment (30.0% vs. 13.0%, p = .001) and overall activity impairment (39.5% vs. 17.2%, p < .001) than the non-physically-impaired group after adjusting for covariates. CONCLUSIONS This study identified age, BMI, diabetes-related comorbidities, history of cardiovascular events and lack of exercise as key predictors associated with physical impairment in older patients with T2DM in Japan, which predicted low work productivity as well as activity impairment. This study provides support that physical impairment in patients with T2DM may lead to low work productivity and activity impairment. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/03007995.2020.1846170.
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Affiliation(s)
- Atsushi Araki
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital,Tokyo,Japan
| | - Hiroyuki Umegaki
- Department of Geriatrics and Community Healthcare, Graduate School of Medicine, University of Nagoya,Nagoya,Japan
| | - Takashi Sakurai
- The Center for Comprehensive Care and Research on Demented Disorders, National Center for Geriatrics and Gerontology,Obu,Japan
| | - Yuzo Mizuno
- Division of Diabetes & Endocrinology, Kanto Central Hospital,Tokyo,Japan
| | - Mariko Miyao
- Division of Diabetes & Endocrinology, Kanto Central Hospital,Tokyo,Japan
| | - Makoto Imori
- Medicines Development Unit Japan, Eli Lilly Japan,Kobe,Japan
| | - Shuichi Suzuki
- Medicines Development Unit Japan, Eli Lilly Japan,Kobe,Japan
| | | | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine,Chiba,Japan
| | - Tomio Onuma
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center,Tokyo,Japan
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Mental component of health-related quality of life is an independent predictor of incident functional disability among community-dwelling older people: a prospective cohort study. Qual Life Res 2021; 30:1853-1862. [PMID: 33559861 DOI: 10.1007/s11136-021-02780-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Previous studies have reported a positive association between poor health-related quality of life (HRQOL) and disability mainly in relation to the physical component of HRQOL. Given the mental component's responsivity to interventions, this study aimed to investigate whether the mental component of HRQOL independently predicted functional disability. METHODS We targeted all residents aged ≥ 65 years in one municipality and analyzed 3858 men and 4475 women without disability at baseline (November 2016). HRQOL was measured using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 Health Survey. At 3-year follow-up (October 2019), incident functional disability was measured, defined as a new certification according to the Japanese long-term care insurance system. Multivariable Poisson regression models stratified by gender were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for functional disability. RESULTS Among both genders, there was a significant dose-response relationship between better MCS and lower risk of functional disability, independent of potential confounders including the PCS (P for trend = 0.026 in men and 0.003 in women). Compared with the worst MCS group, the CIRs (95% CIs) for functional disability in the second worst, the middle, the second best, and the best MCS quintile groups were 1.09 (0.80-1.48), 0.58 (0.40-0.85), 0.90 (0.59-1.37), and 0.70 (0.48-1.02) for men, and 0.76 (0.58-1.00), 0.62 (0.46-0.84), 0.73 (0.53-0.99), and 0.63 (0.48-0.85) for women, respectively. CONCLUSION The MCS is an independent predictor of functional disability among high-functioning older adults. This suggests that strategies focused on mental HRQOL are important for realizing a healthy, long-lived society.
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Miyata K, Yoshikawa T, Harano A, Ueda T, Ogata N. Effects of visual impairment on mobility functions in elderly: Results of Fujiwara-kyo Eye Study. PLoS One 2021; 16:e0244997. [PMID: 33513151 PMCID: PMC7845963 DOI: 10.1371/journal.pone.0244997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/18/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine whether there is a significant association between a visual impairment (VI) and mobility functions in an elderly Japanese cohort. The subjects of this study were part of the Fujiwara-kyo Eye Study, a cross sectional epidemiological study of elderly individuals conducted by Nara Medical University. Participants were ≥70-years who lived in the Nara Prefecture. All underwent comprehensive ophthalmological examinations, and a VI was defined as a best-corrected visual acuity (BCVA) worse than 20/40 in the better eye. The associations between the BCVA and walking speed and one-leg standing time were determined. The medical history and health conditions were evaluated by a self-administered questionnaire. A total of the 2,809 subjects whose mean age was 76.3 ± 4.8 years (± standard deviation) were studied. The individuals with a VI (2.1%) had significantly slower walking speeds and shorter one-leg standing times than that of the non-VI individuals (1.5±0.4 vs 1.7±0.4 m/sec, P<0.01; 17.1±19.6 vs 27.6±21.3 sec, P<0.01, respectively). Univariate logistic regression found that the odds ratio (OR) for the slower walking speed (<1 m/sec) in the VI individuals was significantly higher at 7.40 (3.36–16.30;95% CI, P <0.001) than in non-VI individuals. It was still significantly higher at 4.50 (1.87–10.85;95% CI, P = 0.001) in the multivariate logistic regression model after adjusting for the BCVA, age, sex, current smoking habit, and health conditions. Our results indicate that the walking speed and one-leg standing times were significantly associated with VI.
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Affiliation(s)
- Kimie Miyata
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | - Tadanobu Yoshikawa
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | - Akihiro Harano
- Department of Orthopedics, Yamatotakada Municipal Hospital, Yamatotakada, Japan
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
- * E-mail:
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Geriatric syndromes and the cumulative impacts on quality of life in older people with type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-020-00848-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Jalenques I, Rondepierre F, Rachez C, Lauron S, Guiguet-Auclair C. Health-related quality of life among community-dwelling people aged 80 years and over: a cross-sectional study in France. Health Qual Life Outcomes 2020; 18:126. [PMID: 32381010 PMCID: PMC7206748 DOI: 10.1186/s12955-020-01376-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/23/2020] [Indexed: 12/20/2022] Open
Abstract
Background The proportion of people living to a very old age is continuously increasing. One of the possibilities explored in policies and services to meet this health and societal challenge is to encourage the very old to continue living at home. This initiative is in line with the wishes of most elderly people. However, owing to the great changes that occur during old age attention should be paid to health-related quality of life (HRQoL). The aims of this study were to assess HRQoL in French community-dwelling people aged 80 years and over and to investigate the sociodemographic and health characteristics and life events associated with HRQoL. Methods A cross-sectional study was conducted in France to assess the HRQoL of people aged 80 years or more living at home. All people recruited were sent a letter explaining the aim of the study and requesting their consent to take part. Those who accepted then received a series of sociodemographic and medical questionnaires, a questionnaire concerning life events of the previous 12 months and the LEIPAD questionnaire, which assesses HRQoL in elderly people. Results The data of 184 participants (54.9% female) with a mean age of 83.9 years (almost 40% older than 85 years), were analysed. Low scores, indicating better HRQoL, were obtained on the ‘Self-Care’ and ‘Depression and Anxiety’ scales with 50.9 and 40.8% of responders, respectively, having the minimum score of zero. The highest score was found on the ‘Sexual Functioning’ scale, with 59.1% of participants having the maximum score of 100. Elderly females declared a significantly less satisfactory HRQoL. Deteriorating health, an unsatisfactory environment, not being able to drive, perceived modest income and financial worries negatively affected HRQoL. Conclusion Identifying factors in our study that are potential determinants of HRQoL would be of direct benefit for individuals. Concrete public policy initiatives concerning means of transport, living environment and financial resources could then be implemented to improve the HRQoL of very old community-dwelling individuals.
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Affiliation(s)
- Isabelle Jalenques
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, 58 rue Montalembert, Cedex 1, 63003, Clermont-Ferrand, France.
| | - Fabien Rondepierre
- CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, Clermont-Ferrand, France
| | - Chloé Rachez
- CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, Clermont-Ferrand, France
| | - Sophie Lauron
- CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Clermont-Ferrand, France
| | - Candy Guiguet-Auclair
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
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Diabetes in women and health-related quality of life in the whole family: a structural equation modeling. Health Qual Life Outcomes 2019; 17:178. [PMID: 31806030 PMCID: PMC6896711 DOI: 10.1186/s12955-019-1252-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 11/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although several studies indicate the effects of diabetes type 2 on health-related quality of life (HRQoL) in female subjects, the related impact of the disease on HRQoL in their family members has rarely been the focus of the empirical research. In this study we aim to investigate associations between diabetes in women and the HRQoL in these women and their family members, using the structural equation modeling (SEM). Methods This family-based study was conducted on 794 women (11.1% with diabetes) as well as their spouses and children who participated in the Tehran Lipid and Glucose Study (TLGS) from 2014 to 2016. Data on HRQoL were collected using the Iranian version of the Short-Form 12-Item Health Survey version 2 (SF-12v2) and the Pediatric Quality of Life Inventory version™ 4.0 (PedsQL). SEM was conducted to evaluate the network of associations among studied variables. Data were analyzed using IBM SPSS Statistics & AMOS version 23 software. Results Mean age of women was 41.37 ± 5.32 years. Diabetes in women significantly affected their mental HRQoL (β = − 0.11, P < 0.01) but showed no significant direct associations with physical and mental HRQoL in their spouses or their children. However, poor mental HRQoL in women with diabetes was associated with decrease in both physical (β = − 0.02, P = 0.013) and mental (β = − 0.03, P < 0.01) HRQoL in their spouses and total HRQoL score in children (β = − 0.02, P < 0.01). Conclusions Among women with diabetes type 2, beyond its effect on their mental HRQoL per se, demonstrated a negative association with the self-assessment of health status in their spouses and children. Such familial consequences are mainly attributed to the negative effect of the disease on the mental rather than the physical HRQoL in women with diabetes.
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Yang YC, Lin MH, Wang CS, Lu FH, Wu JS, Cheng HP, Lin SI. Geriatric syndromes and quality of life in older adults with diabetes. Geriatr Gerontol Int 2019; 19:518-524. [PMID: 30957935 DOI: 10.1111/ggi.13654] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/28/2019] [Accepted: 02/15/2019] [Indexed: 12/18/2022]
Abstract
AIM To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes. METHODS Community-dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini-Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL-BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life. RESULTS Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = -0.278~0.460, all P < 0.001). CONCLUSIONS Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518-524.
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Affiliation(s)
- Yi-Ching Yang
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Hsing Lin
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Chong-Shan Wang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Alian Health Clinic, Kaohsiung County, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Ping Cheng
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sang-I Lin
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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12
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Franch-Nadal J, García-Gollarte F, Pérez Del Molino A, Orera-Peña ML, de Miguel MR, Melogno-Klinkas M, de Paz HD, Aceituno S, Rodríguez-Fortúnez P. Physicians' and Pharmacists' Clinical Considerations for Elderly Patients with Type 2 Diabetes Mellitus: The IMPLICA2 Study. Clin Drug Investig 2019; 39:73-84. [PMID: 30315498 DOI: 10.1007/s40261-018-0713-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Management of elderly patients with type 2 diabetes mellitus (T2DM) is complex due to their age-related conditions. Several clinical guidelines provide specific recommendations for management of these patients but little is known about their implementation in clinical practice. OBJECTIVE To describe physician and community pharmacist perceptions and routine clinical practice in the management of elderly T2DM patients. METHODS Cross-sectional study. RESULTS A total of 993 physicians and 999 community pharmacists completed the questionnaire. More physicians than pharmacists agreed on the need to establish more flexible HbA1c targets for elderly (79.4% vs. 30.6%; p < 0.001) and frail (92.6% vs. 31.4%; p < 0.001) patients than for the general diabetic population. HbA1c targets < 7.5% for elderly patients and < 8.5% for frail patients (as recommended by the principle guidelines) were set by 38.9% and 28.7% of physicians, respectively. Furthermore, 62.8% of physicians stated they follow guideline recommendations but, based on their prescription decisions for hypothetical patients, less than 50% were aligned with them. In addition, 73.1% of physicians monitor treatment adherence, mainly by using dispensing control (59.1%). Specific nutritional approaches for elderly patients are provided by 62.9% of physicians and 56.0% of pharmacists, whilst 57.4% and 21.7%, respectively, deliver specific physical exercise programs. CONCLUSIONS Low adherence to guideline recommendations (i.e. setting more stringent HbA1c targets or delaying treatment intensification) may lead to suboptimal glycaemic control in elderly patients. The standardization of processes, extensive monitoring of patient treatment adherence and providing advice regarding specific personal lifestyle habits may improve the management of elderly T2DM patients.
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Affiliation(s)
- Josep Franch-Nadal
- CAP Drassanes Raval-Sud, Barcelona, Spain.,CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
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13
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The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia. PLoS One 2018. [PMID: 29534070 PMCID: PMC5849313 DOI: 10.1371/journal.pone.0192417] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. METHODS A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. RESULTS 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). CONCLUSION The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12616000210471.
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14
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Wernecke J. [Therapeutic goals for elderly people with diabetes]. MMW Fortschr Med 2018; 160:41-45. [PMID: 29556998 DOI: 10.1007/s15006-018-0289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jürgen Wernecke
- Agaplesion Diakonieklinikum Hamburg gGmbH, Hohe Weide 17, D-20259, Hamburg, Deutschland.
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15
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Miyata K, Yoshikawa T, Morikawa M, Mine M, Okamoto N, Kurumatani N, Ogata N. Effect of cataract surgery on cognitive function in elderly: Results of Fujiwara-kyo Eye Study. PLoS One 2018; 13:e0192677. [PMID: 29462175 PMCID: PMC5819799 DOI: 10.1371/journal.pone.0192677] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/29/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose To determine whether there is a significant association between prior cataract surgery and cognitive function in an elderly Japanese cohort. Setting Nara Medical University, Nara, Japan. Design The Fujiwara-kyo Eye Study was a cross-sectional epidemiological study. Methods The subjects were ≥ 68-years who lived in the Nara Prefecture and responded to recruitment notices. All of the subjects received comprehensive ophthalmological examinations, and answered questionnaires on their socio-demographic and medical history including prior cataract surgery. The association between prior cataract surgery and cognitive function was determined. Results A total of the 2764 subjects whose mean age was 76.3±4.8 years (±standard deviation) was studied. Of these, 668 individuals (24.2%) had undergone cataract surgery. Of these, 150 (5.4%) had dementia as determined by the Mini-Mental State Examination (MMSE) score ≤23, and 877 individuals (31.7%) had mild cognitive impairment (MCI; MMSE score 24–26). The subjects who had prior cataract surgery had significantly lower odds ratio (OR) of having MCI (OR = 0.78, 95% confidence interval; CI 0.64–0.96, P = 0.019) than those who had not had cataract surgery after adjusting for age, sex, body mass index, education, hypertension, diabetes, depression, and history of stroke. The OR was still lower when the visual acuity was also added to the adjusted factors (OR 0.79, 95% CI 0.64–0.97, P = 0.025). However, prior cataract surgery did not contribute significantly to the low OR for dementia. Conclusions Cataract surgery may play a role in reducing the risk of developing MCI independently of visual acuity but not for dementia.
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Affiliation(s)
- Kimie Miyata
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | - Tadanobu Yoshikawa
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | | | - Masashi Mine
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | - Nozomi Okamoto
- Department of Community Health and Epidemiology, Nara Medical University, Kashihara, Nara, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University, Kashihara, Nara, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
- * E-mail:
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16
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Nguyen HTT, Moir MP, Nguyen TX, Vu AP, Luong LH, Nguyen TN, Nguyen LH, Tran BX, Tran TT, Latkin CA, Zhang MW, Ho RC, Vu HTT. Health-related quality of life in elderly diabetic outpatients in Vietnam. Patient Prefer Adherence 2018; 12:1347-1354. [PMID: 30100711 PMCID: PMC6067618 DOI: 10.2147/ppa.s162892] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is an important indicator for designing care and treatment services for patients with diabetes. This is especially true given its rapid increase among the elderly population in Vietnam. HRQoL data in elderly diabetic Vietnamese are currently limited. This study aimed to 1) measure the HRQoL of elderly patients with type 2 diabetes (T2DM) in Vietnam and 2) identify related factors and their relationship with HRQoL. PATIENTS AND METHODS A cross-sectional study was conducted. We recruited 171 patients aged ≥60 years with T2DM at the Outpatient Department, National Geriatric Hospital from June to November 2015. Patients were asked to evaluate their health status using the EuroQol Five Dimensions Three Levels (EQ-5D-3L) and the Visual Analog Scale (VAS). Sociodemographic, diabetic treatment, and management characteristics were collected. Multivariate Tobit regression was used to determine which factors were associated with HRQoL, and the strength of this relationship. RESULTS Patients reported some problems in all areas of the EQ-5D: pain/discomfort (50.9%), mobility (33.3%), anxiety/depression (24.0%), usual activities (21.1%), and self-care (10.5%). The mean EQ-5D index score was 0.80 (SD=0.20), and the mean EQ-VAS was 57.5 (SD=14.4). Patients who were male, lived in an urban area, could afford treatment, were taking fewer medications, and monitored blood pressure often (1-4 times a week) had a higher EQ-5D index when compared to other groups. Meanwhile, a longer duration of diabetes and older age were negatively associated with the EQ-5D index. Patients with any comorbidity had lower VAS scores than their counterparts. CONCLUSION The presence of diabetes and comorbidity were responsible for a significant decrease in HRQoL. Screening and identifying health problems, providing prompt treatment, and facilitating self-management among patients have the potential to increase diabetic patients' HRQoL.
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Affiliation(s)
- Huong Thi Thu Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Mackenzie Pi Moir
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Thanh Xuan Nguyen
- National Geriatric Hospital, Hanoi, Vietnam,
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | | | - Long Hoang Luong
- National Geriatric Hospital, Hanoi, Vietnam,
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | - Tam Ngoc Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Long Hoang Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Melvyn Wb Zhang
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore
| | - Roger Cm Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Huyen Thanh Thi Vu
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
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Agner VFC, Garcia MC, Taffarel AA, Mourão CB, da Silva IP, da Silva SP, Peccin MS, Lombardi I. Effects of concurrent training on muscle strength in older adults with metabolic syndrome: A randomized controlled clinical trial. Arch Gerontol Geriatr 2017; 75:158-164. [PMID: 29306767 DOI: 10.1016/j.archger.2017.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/06/2017] [Accepted: 12/19/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Metabolic syndrome is highly prevalent among older adults. Concurrent training comprises muscle strengthening and aerobic exercise. OBJECTIVE Determine the effects of a concurrent training program on muscle strength, walking function, metabolic profile, cardiovascular risk, use of medications and quality of life among older adults with metabolic syndrome. METHODS A randomised, controlled, blind, clinical trial was conducted in the city of Santos, state of São Paulo, Brazil, involving 41 male and female older adults. The participants were randomly allocated to a control group (n = 18) and intervention group (n = 23) and were submitted to the following evaluations: strength - 1 maximum repetition (1MR) for 12 muscle groups; the Six-Minute Walk Test (6MWT); blood concentrations of cholesterol and glucose; the use of medications; and the administration of the SF-36 questionnaire. The intervention was conducted twice a week over a total of 24 sessions of concurrent training: 50 min of strength exercises (40-70% 1MR) and 40 min of walking exercises (70-85% maximum heart rate). RESULTS Increases in muscle strength were found in the upper and lower limbs in the inter-group analysis and a greater distance travelled on the 6MWT was found in the intervention group (p = 0.001). The intervention group demonstrated a reduction in the consumption of biguanides (p = 0.002). No changes were found regarding metabolic profile, cardiovascular risk or self-perceived quality of life. CONCLUSION The findings of this clinical trial can be used for the prescription of concurrent training for older adults with metabolic syndrome for gains in muscle strength and walking distance as well as a reduction in the use of biguanides.
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Affiliation(s)
- Vania Fernanda Clemente Agner
- Interdisciplinary Postgraduate Program in Health Sciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil
| | - Marcia Carvalho Garcia
- Department of Biosciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil
| | - Andre Andriolli Taffarel
- Interdisciplinary Postgraduate Program in Health Sciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil
| | - Camila Baudini Mourão
- Interdisciplinary Postgraduate Program in Health Sciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil
| | | | - Sara Pereira da Silva
- Interdisciplinary Postgraduate Program in Health Sciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil
| | - Maria Stella Peccin
- Department of Human Movement Sciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil
| | - Império Lombardi
- Department of Human Movement Sciences, Federal University of São Paulo, Baixada Santista Campus, SP, Brazil.
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18
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Mizuno H, Ekuni D, Maruyama T, Kataoka K, Yoneda T, Fukuhara D, Sugiura Y, Tomofuji T, Wada J, Morita M. The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: A randomized clinical trial. PLoS One 2017; 12:e0188171. [PMID: 29145468 PMCID: PMC5689834 DOI: 10.1371/journal.pone.0188171] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/31/2017] [Indexed: 12/17/2022] Open
Abstract
Aim The purpose of this study was to investigate the effects of non-surgical periodontal treatment on hemoglobinA1c (HbA1c) levels, oxidative stress balance and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM) compared to no periodontal treatment (simple oral hygiene instructions only). Methods The design was a 6-month, single-masked, single center, randomized clinical trial. Patients had both T2DM and chronic periodontitis. Forty participants were enrolled between April 2014 and March 2016 at the Nephrology, Diabetology and Endocrinology Department of Okayama University Hospital. The periodontal treatment group (n = 20) received non-surgical periodontal therapy, including scaling and root planing plus oral hygiene instructions, and consecutive supportive periodontal therapy at 3 and 6 months. The control group (n = 17) received only oral hygiene instructions without treatment during the experimental period. The primary study outcome was the change in HbA1c levels from baseline to 3 months. Secondary outcomes included changes in oxidative stress balance (Oxidative-INDEX), the Diabetes Therapy-Related QOL and clinical periodontal parameters from baseline to 3 months and baseline to 6 months. Results Changes in HbA1c in the periodontal treatment group were not significantly different with those in the control group at 3 and 6 months. Systemic oxidative stress balance and QOL significantly improved in the periodontal treatment group compared to the control group at 3 months. In the subgroup analysis (moderately poor control of diabetes), the decrease in HbA1c levels in the periodontal treatment group was greater than that in the control group at 3 months but not significant. Conclusions In T2DM patients, non-surgical periodontal treatment improved systemic oxidative stress balance and QOL, but did not decrease HbA1c levels at 3 months follow-up. Trial registration Current Controlled Trials UMIN-ICDR UMIN 000013278 (Registered April 1, 2014).
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Affiliation(s)
- Hirofumi Mizuno
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama, Japan
- * E-mail:
| | - Takayuki Maruyama
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Kota Kataoka
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiki Yoneda
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Daiki Fukuhara
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshio Sugiura
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takaaki Tomofuji
- Department of Community Oral Health, Asahi University School of Dentistry, Mizuho, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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19
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Miyata K, Yoshikawa T, Mine M, Nishi T, Okamoto N, Ueda T, Kawasaki R, Kurumatani N, Ogata N. Cataract Surgery and Visual Acuity in Elderly Japanese: Results of Fujiwara-kyo Eye Study. Biores Open Access 2017; 6:28-34. [PMID: 28451472 PMCID: PMC5397236 DOI: 10.1089/biores.2017.0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to determine the presence of prior cataract surgery and best-corrected visual acuity (BCVA) in an elderly Japanese cohort. The Fujiwara-kyo Eye Study was a prospective, population-based, cross-sectional epidemiological study. The subjects were ≥68 years who lived in the Nara Prefecture and responded to recruitment notices. All of the subjects underwent comprehensive ophthalmological examinations, and the sociodemographic information and medical history, including prior cataract surgery, were obtained by answers to a questionnaire. The associations between the BCVA, age, sex, and history of cataract surgery were determined. A total of 2,873 subjects whose mean age was 76.3 ± 4.9 (mean ± standard deviation) years were studied. The mean BCVA was −0.020 ± 0.14 logarithm of the minimum angle of resolution units, and it was significantly better in the group with education ≥13 years (p < 0.01). Overall, 24.2% of the subjects had undergone cataract surgery, and 41.7% of the subjects ≥80 years had undergone cataract surgery. The incidence of prior cataract surgery increased with increasing age (p < 0.001 for trend). The mean BCVA of eyes with cataract surgery was significantly better than that of eyes without cataract surgery in subjects ≥80 years (p < 0.01). Visual acuity was generally good in this cohort of elderly Japanese subjects. In this cohort, 24.2% of the subjects had undergone cataract surgery, and the subjects ≥80 years had better BCVA than those without cataract surgery.
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Affiliation(s)
- Kimie Miyata
- Department of Ophthalmology, Nara Medical University, Kashihara, Japan
| | | | - Masashi Mine
- Department of Ophthalmology, Nara Medical University, Kashihara, Japan
| | - Tomo Nishi
- Department of Ophthalmology, Nara Medical University, Kashihara, Japan
| | - Nozomi Okamoto
- Department of Epidemiology and Preventive Medicine, Nara Medical University, Kashihara, Japan
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University, Kashihara, Japan
| | - Ryo Kawasaki
- Department of Public Health, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Norio Kurumatani
- Department of Epidemiology and Preventive Medicine, Nara Medical University, Kashihara, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, Kashihara, Japan
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20
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Fisher L, Tang T, Polonsky W. Assessing quality of life in diabetes: I. A practical guide to selecting the best instruments and using them wisely. Diabetes Res Clin Pract 2017; 126:278-285. [PMID: 28153545 DOI: 10.1016/j.diabres.2016.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 09/28/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
The rapid development of new medications and devices in diabetes research and clinical care has led to an increased need to assess their impact on health-related quality of life (HRQOL). Unfortunately, the lack of consensus definitions and guidelines has led to the use of HRQOL measures that are often imprecise and inappropriate. The goal of this report is to provide a practical structure to the definition and measurement of HRQOL in diabetes research and clinical care. Following a brief historical background to provide context, we define HRQOL and provide a three-step framework for scale selection: identify the specific, proximal intervention targets; decide how reaching these targets will affect HRQOL; and select appropriate measures based on sample diversity, the intervention and the targets using a 2×2 grid (generic vs. diabetes specific measures; global vs. component measures). Practical tips for scale selection include: gaining patient input to document important potential HRQOL effects, varying scale selection by patient characteristics, considering common HRQOL measurement problems, and considering the timing of HRQOL assessment. We emphasize the importance of a careful, planned evaluation of HRQOL in diabetes, rather than an "off the shelf" approach.
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Affiliation(s)
| | - Tricia Tang
- University of British Columbia, Vancouver, Canada.
| | - William Polonsky
- Behavioral Diabetes Institute, University of California, San Diego, CA, USA.
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21
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Ovayolu Ö, Ovayolu N, Doğru A, Özkaya M. The Challenge of Diabetes in the Elderly and Affecting Factors: A Turkish Study. Holist Nurs Pract 2016; 29:272-9. [PMID: 26263288 DOI: 10.1097/hnp.0000000000000102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was conducted with the goal of evaluating the challenge of diabetes in elderly individuals and affecting factors. This descriptive study was conducted with 88 diabetic patients 65 years of age or older who were admitted to the endocrinology and metabolism disorders outpatient clinic data of the study collected by using a questionnaire prepared by the researchers and the Elderly Diabetes Burden Scale. Total score of the scale varies between 19 and 92 points. While a higher score indicates a higher burden a lower score indicates a lower burden, data were analyzed by using Student t test, 1-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis test. Subscale and total mean scores of patients were as follows: 9.4 ± 3.2 for symptom burden; 12.4 ± 3.4 for social burden; 11.4 ± 3.3 for burden by dietary restrictions; 11.9 ± 3.7 for burden of worry about diabetes; 4.3 ± 1.3 for burden from treatment dissatisfaction; 9.4 ± 4.6 for burden by oral antidiabetic drugs or insulin; and 58.5 ± 9.6 for total diabetes burden score. Diabetes burden was found to be higher for patients who were at an advanced age, single, female, had a lower income, receiving oral antidiabetic or insulin treatment, and had diabetes duration of 6 to 11 years, a concomitant chronic condition or a diabetic person among first-degree relatives and who did not come for regular follow-up visits, had no assistance for their care, and who stated a poor quality of life and treatment compliance. Elderly diabetic patients were found to have a high total Elderly Diabetes Burden Scale score, and the highest scores were observed for the subscales of burden by dietary restrictions, social burden, and burden of worry about diabetes. Thus, it could be recommended to perform appropriate nursing interventions in order to assess and reduce diabetes challenge during planning of necessary treatment and care in elderly diabetic patients.
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Affiliation(s)
- Özlem Ovayolu
- Faculty of Health Science, Gaziantep University, Gaziantep, Turkey (Drs Ö. Ovayolu and N. Ovayolu); Gaziantep University Medical Faculty Hospital, Gaziantep, Turkey (Ms Doğru); and Department of Endocrinology and Metabolic Diseases, Gaziantep University, School of Medicine, Gaziantep, Turkey (Dr Özkaya)
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Mitoma J, Kitaoka M, Asakura H, Anyenda EO, Hori D, Tao NTT, Hamagishi T, Hayashi K, Suzuki F, Shimizu Y, Tsujiguchi H, Kambayashi Y, Hibino Y, Konoshita T, Sagara T, Shibata A, Nakamura H. Prevalence of Chronic Pain, Especially Headache, and Relationship with Health-Related Quality of Life in Middle-Aged Japanese Residents. Health (London) 2016. [DOI: 10.4236/health.2016.81014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Asakura T, Funatsu Y, Ishii M, Namkoong H, Yagi K, Suzuki S, Asami T, Kamo T, Fujiwara H, Uwamino Y, Nishimura T, Tasaka S, Betsuyaku T, Hasegawa N. Health-related quality of life is inversely correlated with C-reactive protein and age in Mycobacterium avium complex lung disease: a cross-sectional analysis of 235 patients. Respir Res 2015; 16:145. [PMID: 26635226 PMCID: PMC4668618 DOI: 10.1186/s12931-015-0304-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 11/19/2015] [Indexed: 01/08/2023] Open
Abstract
Background Mycobacterium avium complex (MAC) lung diseases generally cause chronic disease in immunocompetent hosts. Although a few studies have examined health-related quality of life (HRQL) in patients with MAC lung disease, there have been no large studies. This study aimed to evaluate HRQL and its correlation with clinical outcomes in MAC lung disease. Methods A cross-sectional study was conducted at Keio University Hospital to investigate the factors associated with HRQL in pulmonary nontuberculous mycobacterial diseases. MAC lung diseases were diagnosed according to the 2007 ATS/IDSA guidelines for nontuberculous mycobacterial diseases. The 36-item short form health survey (SF-36) was administered to assess clinical outcomes. Clinical variables included treatment status, latest haematological data, and bacterial smear and culture results. Results The SF-36 scores for the 235 patients (median age, 69 years; 45 men and 190 women) with MAC lung disease, except for the bodily pain and mental health subscale scores, were significantly lower than the Japanese population norms. In the multivariable analyses, current treatment for MAC and a positive sputum smear or culture within the past year were significantly associated with lower SF-36 scores. C-reactive protein (CRP) and age showed stronger inverse correlations with SF-36 scores. Conclusions HRQL, especially the physical component, was impaired in patients with MAC lung diseases; this appears to be related with current treatment status, positive sputum smear or culture within the previous year, and particularly CRP and age. Further studies including qualitative assessments are needed to investigate the efficacy of CRP as a marker for progression or treatment response in MAC lung disease. Trial registration Clinical trial registered with UMIN (UMIN000007964).
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Affiliation(s)
- Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yohei Funatsu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Ho Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kazuma Yagi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Shoji Suzuki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takahiro Asami
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Tetsuro Kamo
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Hiroshi Fujiwara
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan.
| | - Yoshifumi Uwamino
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan.
| | | | - Sadatomo Tasaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Naoki Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan.
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Tsutsui H, Nomura K, Ohkubo T, Ozaki N, Kusunoki M, Ishiguro T, Oshida Y. Identification of physical and psychosocial problems associated with diabetic nephropathy using the International Classification of Functioning, Disability and Health Core Set for Diabetes Mellitus. Clin Exp Nephrol 2015; 20:187-94. [DOI: 10.1007/s10157-015-1143-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
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Stock S, Pitcavage JM, Simic D, Altin S, Graf C, Feng W, Graf TR. Chronic Care Model Strategies In The United States And Germany Deliver Patient-Centered, High-Quality Diabetes Care. Health Aff (Millwood) 2014; 33:1540-8. [DOI: 10.1377/hlthaff.2014.0428] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Stephanie Stock
- Stephanie Stock ( ) is a professor at the Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, in Germany
| | - James M. Pitcavage
- James M. Pitcavage is a project manager at the Center for Health Research, Geisinger Health System, in Danville, Pennsylvania, and a PhD candidate in the Department of Health Policy and Administration at the Pennsylvania State University, in University Park
| | - Dusan Simic
- Dusan Simic is a scientific associate at the Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne
| | - Sibel Altin
- Sibel Altin is a scientific associate at the Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne
| | - Christian Graf
- Christian Graf is head of the Department of Product Development, Health Care Management, and Prevention at Barmer, in Wuppertal, Germany
| | - Wen Feng
- Wen Feng is a biostatistical analyst at the Center for Health Research, Geisinger Health System
| | - Thomas R. Graf
- Thomas R. Graf is chief medical officer for population health and longitudinal care service lines, Geisinger Health System
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