Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 27 , Issue 1
Showing 1-15 articles out of 15 articles from the selected issue
  • Fumio Kuzuya
    1990 Volume 27 Issue 1 Pages 1-6
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    On this paper, author reviews studies on the relationship between atherogenesis and aging.
    An increase in serum lipid peroxide level increased the number of circulating vascular endothelial cells. This indicates that the free radical is an injury factor for endothelial cells.
    In addition macrophages discharged the active oxygen upon stimulation and incorporated oxidized low density lipoprotein. These results suggested that macrophages play a main role in the initiation of atheroma formation.
    A very small dose of H2O2 induced platelet aggregation in vitro.
    Thrombin has chemotactic and chemokinetic activity for the smooth muscle cell as does fibrinogen, fibronectin and oxydized LDL.
    Conclusion. These results suggest close association through free radicals between the aging process and atherogenesis.
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  • Noboru Yoshimine
    1990 Volume 27 Issue 1 Pages 7-11
    Published: January 30, 1990
    Released: November 24, 2009
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    It is well known that nutrition plays an important role in the maintenance of health through the whole life. Especially, nutrition in the elderly is thought to be neccessary for keeping their life comfortable. How much calories should be needed in the elderly? In our country, daily allowance of total calories is 1600kcal in male and 1400kcal in female in seventh decade respectively. 1460kcal in male and 1270kcal in female over eighty years old are recommended respectively. Protein requirement is about 0.6g/kg of body weight. Fat should be kept as it is. Vitamin and mineral are the another important factors. We investigated the levels of serum vitamin B1 (B1) and B12 (B12) in 26 elderly out-patients. B1 and B12 are within normal ranges and there is no tendency to decline with age. Serum Zinc (Zn) is one of microelements and its deficiency is thought to cause the taste disorder. In 126 male subjects, Zn decreasd significantly with aging. Zn correlated with serum total protein and albumin. There exists some discrepancy in the food habbit between the old and the young: Dietary habits is Japanese style in the former and Western one in the latter. Recently as the old people are increasing in population, those who complain of difficulty in swallowing food are also increasing. In these cases, we should apply the artificial feeding such as central venous hyperalimentation, nasogastric and gastro-fistula feeding, etc. And ratio of these artificial food intake will increase in the near future.
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  • Atsuyoshi Mori
    1990 Volume 27 Issue 1 Pages 12-17
    Published: January 30, 1990
    Released: November 24, 2009
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    Sleep structure is qualitatively and quantitatively changed by aging. The elderly usually go to bed in early evening and wake up in early morning, and they also take several naps in the day time. The polyphasic sleep is one of the typical sleep patterns found in the elderly. Comparing the sleep of the elderly with that of young adults by the method of polysomnography, the characteristics of the sleep of the elderly are in the prolongation of sleep latency, shortening of total sleep time, increase of Stage W and Stage 1, decrease of Stage 3 and 4, and also decrease of Stage REM and the advance of REM phase. Insomnia is a frequently observed symptom in the elderly. The so-called psychophysiological insomnia due to transient psychological or situational stress is common in the elderly. However, insomnia following the mental disturbance (depression), chronic use of drug or alcohol, dementia (vascular or Alzheimer type) are also important in the elderly. Sleep apnea syndrome is recently found as an important cause of insomnia. Concerning the treatment and prevention of insomnia, it is necessary to exclude the causes of insomnia, to improve the envirornmental conditions and to keep the regular rhythm of sleep-wake cycle. It is also important to carefully select and use the adequate hypnotics considering the pharmacokinetics and adverse effects of the drugs in the elderly.
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  • K. Hamaguchi
    1990 Volume 27 Issue 1 Pages 18-21
    Published: January 30, 1990
    Released: November 24, 2009
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  • Gen Konemori, Masahiro Kawanishi, Atsuko Nakamoto, Masataka Hiraoka, G ...
    1990 Volume 27 Issue 1 Pages 22-27
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Serum levels of lipids and apolipoproteins were determined in patients with cerebral infarction during the chronic stage three months after onset, and these patients were classified into the group with diabetes mellitus and that without diadetes mellitus. These levels wre compared with the levels observed in the control group and the diabetes mellitus-only group using the box plot which is a procedure employed in exploratory data analysis. a. Compared to the control group, the levels of T.G., apo B, Apo C-II and Apo C-III were higher, that of HDL-C, was lower, that of LDL-C, tended to be higher and that of Apo A-I tended to be lower in the diabetes mellitus-only group without treatment or under diet treatment alone. b. Compared to the control group, the levels of LDL-C, and Apo B were higher, while those of HDL-C., Apo A-I, and APO A-II were lower in the cerebral infarction-only group. c. Compared to the control group, the level of Apo B was higher, those of T.G. tended to be higher, and that of HDL-C. tended to be lower in the cerebral infarction group with diabetes mellitus, but when compared to the cerebral infarction-only group, the levels of T.G., HDL-C, Apo A-II, Apo C-II and Apo C-III tended to be higher. d. Compared to the control group, the ratio of LDL-C. to Apo B was lower (p<0.05) in the cerebral infarction group with diabetes mellitus and tended to be lower even in the diabetes mellitus-only group.
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  • Yukio Ohhara, Yoshitoshi Mae, Keisuke Sakurada, Tamotsu Miyazaki, Mits ...
    1990 Volume 27 Issue 1 Pages 28-32
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    We measured red blood cell counts, hemoglobin levels, hematocrit values, serum iron levels, total iron binding capacity, transferrin saturation, and serum ferritin levels in 364 elederly subjects in the eighth decade, who conisted of 283 subjects (171 males, 112 females) living in their own homes and 81 subjects (28 males, 53 females) living in an old-age home. The mean values of RBC, Hb, Ht, SI, s-Ft in both male and female subjects living in their own homes were 469×104/μl vs 439× 104/μl, 14.6g/dl vs 13.3g/dl 44.3% vs 40.6%, 95.6μg/dl vs 84.8μg/dl, 50.2ng/ml vs 42.6ng/ml, respectively. On the other hand, the mean values of RBC, Hb, Ht, SI, s-Ft in both male and female subjects living in an old-age home were 421×104/μl vs 390×104/μl, 13.8g/dl vs 12.6g/dl, 39.9% vs 36.7%, 74.2μg/dl vs 58.6μg/dl, 98.8ng/ml vs 69.1ng/ml, respectively. All erythrocyte parameters were significantly lower in females than in males in both groups, and significantly lower in subjects living in an old-age home than in subjects living in their own homes. The erythrocyte parameters of subjects living in their own homes showed little difference compared with those of normal young adults. These results suggest that a sedentary lifestyle in the elderly people contribute to the tendency to have anemia and this is considered to relate to age-associated pathology such as inflammation. As anemia in elderly people often follows a underlying illness, we must always give attention to the factors which cause anemia. Even if we cannot find any abnormality, we should consider anemia to be a sign of disease and continue to follow patients carefully.
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  • Toshiaki Inagaki, Toshiyuki Yamamoto, Kazuya Nokura, Tatsuji Niimi, Yo ...
    1990 Volume 27 Issue 1 Pages 33-39
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    The effect of rehabilitation and prognosis for elderly cases of cerebrovascular dementia were evaluated by comparing the group of the patients receiving rehabilitation with those who did not receive rehabilitation. There were no significant differences in the age, neurological symptoms, psychotic symptoms, physical complications, ADL and Hasegawa's dementia rating scale between the two groups. The main reason for rehabilitation was recurrence of cerebrovascular attack (42.9%), disuse atrophy (42.9%) and bone fracture and others (14.3%). There was significant improvement of ADL in the patients showing a score of more than 10 on Hasegawa's dementia rating scale and in the patients given drugs to improve cerebral circulation and metabolism, but there was no significant improvement of Hasegawa's dementia rating scale. Concerning the prognosis of patients receiving the rehabilitation, there was no change of ADL and Hasegawa's dementia rating scale. In the group of patients which did not receive rehabilitation, significant decrease of ADL was noted, but there was no change of Hasegawa's dementia rating scale.
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  • Soemu Kuroki, Takaya Tsushima, Hiroshi Yoshii, Makoto Hamamoto, Tadasu ...
    1990 Volume 27 Issue 1 Pages 40-44
    Published: January 30, 1990
    Released: November 24, 2009
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    Measurement of HbA1c is widely used to control diabetes mellitus (DM) and is one of the methods to diagnose DM. We adopted the measurement of HBA1c in the annual medical examination of residents at a nursing home for the elderly in order to obtain the normal serum level of HbA1c in the elderly and analyze the influence of aging on HbA1c. HbA1c and the body mass index (BMI) were measured in 968 elderly. HbA1c was distributed from 3.7 to 12.5%. Mean and SD. were 5.03±0.61% and there was no difference of the serum level of HbA1c between males and females. HbA1c was below 6.0% in 95% of all subjects. There was no correlation between age and HbA1c. To determine data trends, we divided the elderly into 4 age groups of 60 to 69 years, 70 to 79 years, 80 to 89 years and 90 or more. With advancing age, HbA1c gradually increased but there was no significant difference of HbA1c among the 3 groups which were younger than the group aged 90 or more. HbA1c was 5.51±1.06% in the group aged more tan 90 years and there was a significant difference in the value of HbA1c between the group aged 90 or more and other groups. Inversely, BMI gradually decreased with age and there was also a significant difference of BMI between the group aged 90 or more and the other groups. These results suggest that there is a difference of metabolic condition between the group aged 90 or more and the other groups. There are several special problems in medical examination for the residents in nursing homes, because among the residents there are slightly demented cases and those handicapped in sight and hearing. In those residents measurement of HbA1c is more practical than measurement of fasting blood sugar and oral glucose tolerance test since the measurement of HbA1c does not require fasting and the glucose load. Moreover, the present study has demonstrated that the predictive value of a positive HbA1c test is high and therefore, measurement of HbA1c is useful in diagnosing DM in the elderly.
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  • Nobuya Kawahata, Masatoshi Yokouchi, Eiichi Ohtomo
    1990 Volume 27 Issue 1 Pages 45-51
    Published: January 30, 1990
    Released: November 24, 2009
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    Candidemias were reviewed in 22 elderly patients hospitalized in Yokufukai Geriatric Hospital. Their ages ranged from 62 to 101 years, with a mean age of 81 years. Sixteen patients had either old cerebrovascular disease or senile dementia. In seven patients, synchronous or metachronous bacteremia in the blood culture was associated with the candidemia. Eighty-six percent of total candidemias were related to intravenous hyperalimentation (IVH). The mean duration from the start of IVH to candidemia was 46 days. Eleven patients (50%) developed candidemia within one month after the beginning of IVH. Fourteen patients had the IVH catheters changed one or more times before the time of positive candida in the blood culture. The mean duration from the start of IVH to candidemia was 59 days. Eight patients, on the other hand, had the catheters unchanged and the mean duration was 23 days. Ninety-six percent were receiving broad-spectrum antibiotic therapy at the time of the positive candida in blood culture. Eight patients developed DIC. The overall mortality was 91% (twenty patients) and thirteen (65%) of them died within one month after the onset of candidemia. There was no difference in mortality when all candidemic patients received no anti-mycotic therapy were compared with the patients given any amount of miconazole or 5-FC. The causes of death for candidemic patients included fungemic shock (6 patients), hemorrhagic shock (4 patients), and shock associated with DIC (3 patients). From the results of this study, candidemia in the elderly was produced by various underlying diseases such as central nervous system diseases or pneumonia. In most patients, long-term antibiotic therapy and IVH were associated with an increased risk factor for candidemia. The prognosis for candidemia was poor in the elderly.
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  • Chigusa Nakatsu, Mikio Arita, Yoshiaki Tomobuchi, Katsuhiro Yamamoto, ...
    1990 Volume 27 Issue 1 Pages 52-56
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    In order to clarify the characteristics of acute myocardial infarction in the elderly, we investigated the clinical profile and long-term prognosis of patients with myocardial infarction in the past 13 years. The early fatality rate (within 30 days after onset) in the relatively younger patients (<65 years old) was 8.8%, and in the older patients (>65 years old) was 29.1%. The fatality rate was significantly higher in older than in younger patients. On coronary and left ventriculography, the older patients showed multi-vessel lesions with decreased ejection fraction and cardiac index. According to the cumulative survival curves related to the coronary risk factors, no significant differences were found with or without smoking or hypertension. However, the long-term prognosis of the patients with controllable hypercholesteremia was better than in uncontrollable patients less than 65 years old. No significant difference was found in patients with hypercholesteremia over age 65. The long-term prognosis of the patients with uncontrollable diabetes mellitus was worse than that of controllable diabetic patients.
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  • Yoshikazu Goriya, Hiroshi Sekimoto, Masayuki Matsumoto, Masao Natto, M ...
    1990 Volume 27 Issue 1 Pages 57-62
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    For the application of the glycemic index (GI) to the therapy of diabetes mellitus (DM) in the elderly, effects of aging and foods were studied in 3 groups of subjects, conducting 3 oral tests of equal calories, namely, glucose, white bread (high-GI meal) and kidney beans (low-GI meal). Group I: healthy adults (N=7), Group II: elderly non-DM (N=7), Group III: elderly DM (N=7). No significant changes with age could be found in blood glucose or GI. However, ingestion of a low-GI meal revealed excellent inhibitory effects upon postprandial glycemic elevation in the elderly diabetics. This implies the clinical usefulness of a low-GI meal (beans) for postprandial glycemic regulation in elderly diabetes mellitus.
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  • Harumi Nagai, Hiroshi Shibata, Hiroshi Haga, Mitsuo Ueno, Yasuo Suyama ...
    1990 Volume 27 Issue 1 Pages 63-68
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    The purpose of the present study is to explore relationship of chewing ability to physical health status in the elderly. Subjects were 722 community elderly adults aged 65 years and over (participation rate 88.6%). They were divided into 2 groups according to chewing ability as rated by a questionnaire: good and bad. Results obtained were as follows; (1) Those who had good ability of chewing accounted for 86% of the subjects. The chewing ability was determined by dental status. Those with more natural teeth were better able to chew. (2) Multiple regression analyses controlled by age and sex showed that good chewing ability had significantly positive effect on weight, body mass and length of time for standing on one leg with eyes open.
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  • Yoriko Shimamoto, Hiroyuki Shimamoto, Hideo Nakamura
    1990 Volume 27 Issue 1 Pages 69-73
    Published: January 30, 1990
    Released: November 24, 2009
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    An elderly case of secondary hypothermia associated with brain tumor was reported. An 84-year old woman developed hypothermia. Although her rectal temperture remained below 37°C, the circadian rhythm of rectal temperature was preserved. Brain computerized tomography (CT) and brain magnetic resonance imaging (MRI) revealed a solitary brain tumor involving the hypothalamus. It appears that her hypothermia may not be due to inability to thermoregulate but to stem from her abnormal target temperatures. Body temperature is normally controlled at around 37°C, but in this patient thermoregulation might have been reset at a lower temperature.
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  • K. Yamashita, S. Kobayashi, K. Okada, H. Koide, H. Fukuda, T. Tsunemat ...
    1990 Volume 27 Issue 1 Pages 74-75
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
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  • 1990 Volume 27 Issue 1 Pages 76-112
    Published: January 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
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