Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 37 , Issue 11
Showing 1-19 articles out of 19 articles from the selected issue
  • Masonori Nishinaga
    2000 Volume 37 Issue 11 Pages 859-865
    Published: November 25, 2000
    Released: November 24, 2009
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  • Maki Moritani, Mitsuo Itakura
    2000 Volume 37 Issue 11 Pages 866-869
    Published: November 25, 2000
    Released: November 24, 2009
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  • Kiyoshi Hashizume
    2000 Volume 37 Issue 11 Pages 870-872
    Published: November 25, 2000
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Hypothyroidism is not rare in aged people. Hashimoto thyroiditis and radiation to the neck region are main causes of hypothyroidism in aged subjects. The symptoms are slowly progressing, and are similar to those of the aged subjects free from thyroid disease. Thus, it is difficult to make a diagnosis of hypo-thyroidism in the elderly. Administration of T4 (not T 3) to patients with hypothyroidism completely releases them from symptoms, indicating that supplement with T4 is important in maintaining QOL. However, a risk of acute coronary syndrome is usually associated with the supplement. Rapid decrease in serum levels of TBG is frequently associated with acute coronary syndrome. Slowly increasing the dose of T4 and monitoring serum thyroxine-binding globulin (TBG) and electrocardiogram (ECG) are important during the period of increasing the dose of T4.
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  • Wataru Kimura
    2000 Volume 37 Issue 11 Pages 873-877
    Published: November 25, 2000
    Released: November 24, 2009
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    Gross and histological examination of the autopsy cases in the aged revealed that: 1. Acute interstitial pancreatitis, which was characterized by rupture of the ducts and ductules associated with profuse intraluminal exudation of polymorphonuclear leucocytes and protein plugs formation, was found in nine cases (0.62%) out of 1457 autopsies. There was scarce parenchymal or fat necrosis which might be caused by impaired secretion by atrophic parenchyma. The interstitial type may represent characteristics of acute pancreatitis in the aged. 2. Pancreatic lithiasis was found in six of 85 cases, or 7.1%. 3. Sites of isolated islets of Langerhans were found in an incidence of 26.5% (53/200), which increased with age. 4. Incidence of endocrine tumors was 10% (6/60) in individuals having histological studies of all sections and 1.6% (12/738) in individuals having histological studies of three random sections of the pancreas. The facts that multiple hormone production was found in as much as 70% and glucagon cells in as much as 85% were characteristics. 5. The atypical epithelia were observed with the highest incidence in the common pancreaticobiliary channel of the papilla of Vater, where carcinoma may arise most frequently. 6. The incidence of cystic lesions increased with age. Small cystic lesions appear to have the potential to progress to malignancy. 7. it may be possible to remove the head of the pancreas while preserving of the vascular arcades and their branches to the duodenum, the bile duct and the papilla of Vater. The artery toward the papilla of Vater is very important for the blood supply of both the papilla and second portion of the duodenum, and should be preserved in duodenum-preserving subtotal resection of the head of the pancreas. Gallbladder carcinoma was found in 94 cases, or 2.1% and gallbladder stone was found in 957 cases, or 21.4% among 4482 cases. Incidence of gallbladder carcinoma was six times higher in the cases with cholecystolithiasis than those without stone.
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  • Masaaki Matsushita, Akira Homma
    2000 Volume 37 Issue 11 Pages 878
    Published: November 25, 2000
    Released: November 24, 2009
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  • Masatoshi Takeda, Kazuhiro Shinosaki, Takashi Nishikawa, Tohihisa Tana ...
    2000 Volume 37 Issue 11 Pages 879-881
    Published: November 25, 2000
    Released: November 24, 2009
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  • Shuichi Awata
    2000 Volume 37 Issue 11 Pages 882-884
    Published: November 25, 2000
    Released: November 24, 2009
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  • Hideki Wada
    2000 Volume 37 Issue 11 Pages 885-888
    Published: November 25, 2000
    Released: November 24, 2009
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    There is a high prevalence of mental disorders in the community population of older adults, especially in medical treatment facilities. Therefore, clinicians who treat geriatric patients cannot neglect the psychiatric vulnerability of the elderly population. The fragility of psychological functioning of the elderly is caused not only by psychological contributors, such as various kinds of experiences of loss, but also by biological factors such as decreases in neurotransmitters and in the number of neurons. Another point geriatric clinicians should pay attention to is the powerful mind-body connection in the elderly. Recent psychoneuroimmunological research demonstrates that depression or other types of emotional stress damages the immune system, which can induce some physical diseases. This is especially true for the elderly, who have weakened cell-mediated immune function and are more susceptible to influence by the damaged immune function caused by such psychiatric dysfunction. Also, depression in the elderly can often lead to malnutrition or dehydration, which can induce various kinds of physical illness. On the other hand, physical illness in the elderly can induce depression, because of the psychological vulnerability of the elderly. Due to the strong mind-body connection in the elderly, the availability of psychiatric care is essential. When providing psychiatric care for the elderly, the clinician should attend to all symptoms, not minimizing the importance of biological treatment, while also trying to support the elderly patients psychologically through acceptance of their need for interdependency and respect for their narcissism.
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  • Masahiko Saito
    2000 Volume 37 Issue 11 Pages 889-890
    Published: November 25, 2000
    Released: November 24, 2009
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  • Nobuyuki Tanaka, Tsutomu Iwaya
    2000 Volume 37 Issue 11 Pages 891
    Published: November 25, 2000
    Released: November 24, 2009
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  • Shigenobu Ishigami
    2000 Volume 37 Issue 11 Pages 892
    Published: November 25, 2000
    Released: November 24, 2009
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  • Kazumi Kawahira
    2000 Volume 37 Issue 11 Pages 893-896
    Published: November 25, 2000
    Released: November 24, 2009
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  • Takashi Nakamura, Etsuo Horikawa, Hidetada Sasaki
    2000 Volume 37 Issue 11 Pages 897-899
    Published: November 25, 2000
    Released: November 24, 2009
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  • Naoki Seki
    2000 Volume 37 Issue 11 Pages 900-902
    Published: November 25, 2000
    Released: November 24, 2009
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  • Kazuo Nakajima
    2000 Volume 37 Issue 11 Pages 903-907
    Published: November 25, 2000
    Released: November 24, 2009
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  • Taiki Komatsu, Naoki Tanaka, Yoshiteru Mutoh, Miho Ohta-Fukushima
    2000 Volume 37 Issue 11 Pages 908-911
    Published: November 25, 2000
    Released: November 24, 2009
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    This study was carried out to investigate the physical functions of the elderly, living in a barrier-free home for the aged and to obtain basic data for giving appropriate guidance on exercise and daily life. A total of 38 women were tested. These included 18 persons (aged 72-87: mean: 80.7) who were living in the home for the aged, and 20 (aged 75-86: mean: 78.3) who voluntarily participated in the “fall prevention school”, established in Tokyo Kosei-Nenkin Hospital.
    The following examinations were done: 1) BMI, Waist/Hip ratio; 2) good walker's index consisting of 10m walking times, maximum length of steps, and 40cm-staircase climbing; and 3) equilibrium examination done by gravinography. Statistical analysis was carried out using a paired t-test (p<0.01). Values for the “good-walker's index” were significantly lower in, the “home” group than in the “school” group (p<0.01). This was especially obvious with 40cm-staircase climbing. Many of the subjects from the institution group required assistance and there was a significant difference in the chisquire square distribution between the two groups. Furthermore, on gravinography, the “home” group had significantly inferior values in total length (cm) and Romberg's ratio (p<0.01). It was clear that residents in the barrier-free home had a significant reduction in good-walker's index, indicating an apparent weakening of physical function.
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  • Ryuichi Kawamoto, Takaaki Doi, Masanobu Okayama, Motomi Satho, Eiji Ka ...
    2000 Volume 37 Issue 11 Pages 912-920
    Published: November 25, 2000
    Released: November 24, 2009
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    This study aimed to evaluate mental health of elderly persons living in the community and understand the various backgrounds and effects of care giving. The study used a questionnaire from similar to the one used by Matsubayashi et al in the Kahoku-cho study. The Japanese Version of General Health Questionnaire 12 (GHQ-12) was used to evaluate mental health. Responses were received from 2, 799 (81.5%) of 3, 432 Numura-cho residents (81.5%). After removing inadequate responses, 1, 268 (36.9%) (575 men and 693 women) were analyzed. Fifty-five men (9.6%) and 69 women (10.0%) were caring for someone at home. Multiple logistic regression analysis which examined the relation between mental health and the background factors such as having someone to care for, revealed that their mental health was significantly poor compared to those having no one to care for (odds ratio (OR)=2.01, 95% confidence interval (CI), 1.29-3.15). As for the relation between the degree of care giving and their mental health, the subjective burden was significantly poor at 72-100% (OR=3.40, 95% CI, 1.71-6.78) and for those with three to eight years of care-giving (OR=2.22, 95% CI, 1.00-4.90), disabled activity of daily living (almost bed ridden) of the cared for person (OR=5.53, 95% CI, 2.23-13.7), severely demented state (OR=5.13, 95% CI, 2.14-12.3), their mental health was significantly poor. However, being able to participate in an event (OR=0.12, 95% CI, 0.03-0.49) and strong emotional support (OR=0.12, 95% CI, 0.03-0.49) were negatively associated with caregivers' psychiatric distress.
    Having someone to care for largely affected mental health of the elderly to subjects living in the community. Services should be devised to serve the needs such as psychological care of care-givers as well as those being cared for.
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  • Haruo Hanyu, Tetsuichi Asano, Daiji Kogure, Hirofumi Sakurai, Toshihik ...
    2000 Volume 37 Issue 11 Pages 921-927
    Published: November 25, 2000
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    We investigated the relation between hippocampal damage and cerebral cortical dysfunction in Alzheimer's disease (AD) using MRI and SPECT. Nineteen patients with AD and 10 control subjects were studied. Hippocampal damage (including hippocampal formation, entorhinal cortex, and parahippocampal white matter) was assessed to evaluate the severity of atrophy and the magnetization transfer ratio (MTR) and cerebral cortical dysfunction was evaluated by quantitative cerebral blood flow (CBF) measurements using SPECT with 99m Tc-ECD. Compared with controls, patients with AD had significantly more atrophy of the medial temporal lobe and a decrease in MTRs of the hippocampus and parahippocampus. There were significant correlations between the severity of hippocampal damage and regional CBF in temporoparietal lobes. Mini-Mental State Examination scores significantly correlated with the severity of hippocampal damage and regional CBFs in temporoparietal lobes. These results suggest that the functional effect of hippocampal damage occurs in temporoparietal lobes in AD, probably due to neuronal disconnections between hippocampal areas (including the entorhinal cortex) and temporoparietal lobes.
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  • Kaori Miyata
    2000 Volume 37 Issue 11 Pages 928-936
    Published: November 25, 2000
    Released: November 24, 2009
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    A follow-up study was conducted to elucidate the factors influencing continuation of home life after returning home from geriatric intermediate care facilities (GICFs). The subjects were 237 elderly persons (56 men, 181 women, average age of 84 years) who were admitted to three GICFs located in the suburbs of Osaka, and their family caregivers. A follow-up study was performed from 1997 to 1998.
    Seventy percent of the elderly were bedridden persons with grade B or C of activities of daily living (ADL) according to the criteria of disabled elderly of the Japanese government. Dementia was observed in 82.3% of them. Family caregivers were sons (30.7%), daughters (27.4%), daughters-in-law (27.8%) and spouses (9.7%). The percentage of families spending all day long with the elderly person was 57.5%. Although the rate of having their own detached house was high, that of a private room for the elderly individuals was only about 60%. Most of the families cared for the elderly before admission to the GICFs. The families desired them to stay in the GICFs for as long as possible. Therefore, the families did not want to take the elderly into their home after discharge and only 45% of the families desired home care after the discharge. Concerning the flow of the 237 elderly subjects, the rate of admission from hospitals was high (60.8%), and that of discharge to hospitals was also high (44.3%). The place of residence at the end of follow-up was the GICF (35.4%), the elderly subject's home (19.0%), and hospital (16.0%). Of the 96 elderly who had returned home from GICFs, 40.6% were re-admitted to GICFs. According to multiple logistic analysis, the factors related to continuation of home life were “the elderly with family caregivers who can always supervise him/her”, and “the elderly without problem behavior”.
    From the results obtained, it is important that in order for disabled elderly individuals to continue their home life, the GICFs must be the function as the center of a comprehensive service system in the community.
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