The purpose of this study was to identify diseases frequently found in elderly populations in rural areas as well as to discuss the role of geriatric physicians in medical care for elderly patients. The study was conducted using ICHPPC-2-Defined (Japan version) which had been compiled by WONCA for the classification of diseases. The acute health problems treated by the clinic consisted of 183 types (2070 items) in 1916 patients seen during 19 months compared to 66 types of chronic problems consisting of 505 items in 179 patients. The most frequent acute complaints and health problems were acute infections of the upper respiratory tract, followed by diseases of the stomach and duodenum, then osteoarthritis and allied conditions. The most common chronic health problems were uncomplicated hypertension, osteoarthritis and allied conditions, osteoporosis, lipid metabolism disorders, complicated hypertension, cataract, and various other illnesses extending over all specialties of medicine. Geriatric physicians are required to have broad and multidisciplinary knowledge and skill to provide comprehensive and continual medical care for elderly patients in rural areas
The purpose of this study was to develop a step-test in order to evaluate age-related change in aerobic capacity. A total of 149 healthy men of age through 18 to 83yrs ascended and descended a single step of 0.2m height in time to a metronome. The step rate increased step-wise through three stages, each of 3min duration; 15, 20 and 25 (step/min) for subjects aged 59 or less, and 10, 15, and 20 (step/min) for those age 60 and over. Using the linear relationship between load and heart rate, physical work capacity (PWC, watt/kg) was estimated as the work load with maximum heart rate predicted by age (220-age). In the elderly group (n=34), heart rate at the end of the last stage was within 60-80% of the maximum heart rate for 25 subjects, and more than 80% for the other 9 subjects. No risky arrhythmia or significant ST change on ECG appeared in any subject. A retest of the step-test for 16 elderly subjects showed its repeatability and a linear relationship between heart rate and oxygen consumption. The results suggested that the step-test was applicable to the elderly in regard to appropriate work load and safety. The PWC significantly declined with aging (r=0.52, p<0.001). Relative aerobic capacity, taking that at age 20 as 100%, was 60% and 53% for subjects aged 60 and 70, respectively, which was in good agreement with available reports which measured oxygen consumption directly.
Twenty post-stroke depressive patients who obtained more than 11 points on Self-Rating Questionnaire for Depression, were treated with 0.075mg/day lisuride maleate for 12 weeks. The drug effect on depression was evaluated quantitatively by the Hamilton Rating Scale for Depression. The relationships between brain CT or MRI and SRQ-D score were investigated in 24 subjects. More than 80% of post-stroke depressive patients improved after lisuride maleate treatment for 8 or 12 weeks. In particular, depressed mood, hypobulia, sleep disturbance, anxiety, etc. were significantly improved compared to the baseline condition. As for the relationships with CT and/or MRI findings, the group with moderate to severe brain atrophy had a significantly higher grade of depressive state than those without.
One hundred senior citizens aged 80 years and over in homes for the aged were evaluated for the incidence of anemia (hemoglobin under 11.0g/dl), Hb concentration, serum iron, and total iron binding capasity (TIBC). The subjects were classified into different groups according to age distribution (80-84, 85-89, over 90), as well as sex and life activity levels. In the 80-84 year age group, the Hb concentration was 0.5g/dl higher than that in the other age groups. The Hb values of the male subjects were 1g/dl higher than the corresponding values for female subjects. Subjects classified as bedridden had Hb values 1.2g/dl lower than those in the groups that had higher activity levels (p<0.001). The incidence of anemia was independent of sex and age differences; however, differences in activity levels were significant (p<0.001). There are 53 patients with some diseases, urinary truct infections, bed sores (over 3cm diameter), chronic bronchitis, progressive cancers and chronic rheumatoid arthritis, which may be origins of anemia. Seventy six percent of bedridden patients have one or two of the above diseases and 30% of non-bedridden patients have these diseases. The difference was statistically significant (p<0.001). In the bedridden group, the differences of the mean Hb levels and the rates of anemia in patients with and without disease were not statistically significant (p>0.1 in both factors). These facts indicate that the bedridden elderly have a high risk of anemia which is independent of some infectious and malignant diseases.