Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 41 , Issue 4
Showing 1-18 articles out of 18 articles from the selected issue
  • Hae-Young Chung, Kuan-Qing Cheng, Gyung-Jin Chung
    2004 Volume 41 Issue 4 Pages 357-364
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
  • Makoto Kammori, Kaiyo Takubo
    2004 Volume 41 Issue 4 Pages 365-368
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
  • Koichi Yokono, Takashi Sakurai
    2004 Volume 41 Issue 4 Pages 369-371
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (1459K)
  • Fuyuki Ishikawa
    2004 Volume 41 Issue 4 Pages 372-374
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (460K)
  • Hidetoshi Endo
    2004 Volume 41 Issue 4 Pages 375-377
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    This paper is written to make clear the new medical system in the elderly and to standardize of Geriatrics and care. There are two major important components in geriatrics and geriatric care which are comprehensive geriatric assessment and team approach. But this is sometimes difficulut to do geriatric medicine. This goal is to make clear the usefulness of comprehensive geriatric assessment (CGA) and team approach. And the research purpose is to make standardization of geriatric medicine and care of elderly patients and organization of professionals.
    I have studied QOL of elderly people in the community. The scale, SF36, was used in this study. I compared with QOL between elderly with dementia and healthy elderly. QOL was studied with statistical analysis of SPSS. Physical function and symptomatic vitality in lower items of QOL were much better in health people than demented elderly. But global subjective health was much better in demented elderly than healthy people in the community. And I made clinical path of dementia for examination in the hospital. The results were clinical path made clear the importance of team approaches and standard of medical course in the hospital. It was helpful in medicine and care and its bindings.
    Dr. Murashima and her group have developed a new check list of screening risk factor of long stay of elderly inpatient. And they studied about the effects of supportive group for discharge using assessment and team approaches. This unit has a good function which support home care of the elderly patients.
    Finally narrative based medicine is very important to take care for the elderly patients. It has been lacked to do the present medicine for the elderly patient by evidence based medicine.
    In conclusion, for the standardization of geriatrics, CGA is useful for support for the frail elderly and team approach is good for staff communication through team conference.
    Download PDF (453K)
  • Masahumi Kuzuya
    2004 Volume 41 Issue 4 Pages 378-380
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (1585K)
  • Kozo Matsubayashi
    2004 Volume 41 Issue 4 Pages 381-383
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (953K)
  • Masashi Tanaka, Takeshi Takeyasu, Noriyuki Fuku, Yasunori Fujita
    2004 Volume 41 Issue 4 Pages 384-386
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (443K)
  • Tetsuro Miki
    2004 Volume 41 Issue 4 Pages 387-389
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (468K)
  • Yoichi Ezura, Mitsuru Emi
    2004 Volume 41 Issue 4 Pages 390-392
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (615K)
  • Ichiro Sakuma
    2004 Volume 41 Issue 4 Pages 393-395
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (1402K)
  • Takeshi Kikutani, Keiko Nishiwaki, Shigeru Inaba, Masahiko Ishida, Mas ...
    2004 Volume 41 Issue 4 Pages 396-401
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    The objective of this study is to examine how occlusal status and swallowing function influence the nutritional improvement achieved by appropriate feeding assistance in the institutionalized elderly.
    We studied 38 residents (mean age 82.04±7.35 years) in a nursing home. Their nutritional status was evaluated by biochemical analysis, and the following results were obtained:
    1) Compared to the levels before intervention, there was a significant increase (p<0.05) after 6 months in serum albumin (3.65±0.32g/dl before and 3.77±0.33g/dl after assistance), HDL cholesterol (49.39±13.39mg/dl before and 53.44±11.27mg/dl after assistance), and hemoglobin (11.39±1.76g/dl before and 11.75±1.75g/dl after assistance) respectively.
    2) Among the edentulous elderly, the change in serum albumin was more significant in the subgroup of elderly wearing dentures (3.64±0.35g/dl before and 3.92±0.40g/dl after assistance).
    3) The serum albumin was significantly lower (p<0.05) in the group of people with swallowing disorders before intervention than the group of people with normal swallowing function (those with swallowing disorder 3.48±0.31; those with normal swallowing function 3.75±0.29g/dl), but it did not change significantly after intervention.
    These results suggested that occlusal support with dentures greatly influences the nutritional intake and appropriate feeding assistance could achieve nutritional improvements for elderly with reduced swallowing function.
    Download PDF (907K)
  • Akinori Takeda, Yoshinari Kawai, Yoko Hattori, Yuki Watanabe, Yutaka M ...
    2004 Volume 41 Issue 4 Pages 402-407
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    We developed a brief scale to evaluate communication ability of the demented elderly. This scale assesses not only abilities related to overall communication such as verbal function, judgment and emotional function, but also non-verbal communication such as eye-contact, nodding and smiling. The scale places little burden on the demented elderly subject and takes only a few minutes to perform, even if the dementia is severe.
    We evaluated 106 demented elderly residents of nursing homes using this brief communication ability scale, and the following results were obtained.
    The validity of this scale was confirmed by the high correlation coefficient between this scale and the formal caregiver questionnaire scores concerning communication ability, and the high-correlation coefficient between this scale and intellectual functions (r=-0.904), emotional functions (r=-0.841) and motor functions (r=-0.679) of dementia syndromes rating scale (Gottfries, Bråne, Steen scale; GBS scale), Hasegawa's Dementia Scale-Revised (HDS-R) (r=0.625) and the Mini-Mental State Examination (MMS) (r=0.733). The reliability of this scale was confirmed by the high interrater reliability coefficient of 0.828, test-retest reliability coefficient of 0.940 and Cronbach alpha coefficient of 0.938.
    These results indicate that the new scale is useful in the assessment of communication ability among the demented elderly.
    Download PDF (939K)
  • Tomoko Yamamoto, Hisayuki Miura, Kazumitsu Nakashima
    2004 Volume 41 Issue 4 Pages 408-413
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    The aim of this study was to investigate cases of nosocomial infection of scabies in the national hospitals in Japan. Questionnaires sent to 183 hospitals and sanatoria were returned by 93. Fifty-three cases in 24 institutions of nosocomial infection were reported in the past 5 years. No nosocomial infection was reported from 7 sanatoria for Hansen's diseases where the patients were relatively older and had higher ADL scores. It took 7.5 weeks on the average to eliminate nosocomial infection and more than 8 weeks were required to control them in the hospitals where more than 10 cases had occurred. Benzyl benzoate, gamma benzene hexachloride, and Pyrethroids, which were not approved as drugs for the treatment of scabies in Japan, were used in the all institutions where nosocomial infection occurred except for one institution. Problems to be solved were as follows; (1)delay of diagnosis and treatment, (2)lack of nursing staff, (3)difficulties of complete isolation due to lack of spaces, inability of patients to understand the need for isolation and also the psychological instability of the isolated patients, (4)recurrence due to the use of ineffective drugs, (5)insufficient information about the prevalence of scabies in the previous institutions, (6)misdiagnosis of non-scabies patients with itchy skin rash as the scabies, (7)inconsisitent care due to poor evaluation of skin lesions.
    Download PDF (798K)
  • Hiroyuki Shimada, Takao Suzuki, Shuichi Obuchi, Taketo Furuna
    2004 Volume 41 Issue 4 Pages 414-419
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    The purpose of this study was to identify the effects of an effort to prevent accidental falls by supervising residents with a high risk of falling in a long-term care facility. Sixty-four subjects with physical disabilities or cognitive impairment who were receiving residential care participated in this study. The fall-risk manager kept the residents under observation through recreational activities or conversation. The intervention was carried out for 50 days, three times per week (Tuesday, Thursday, and Saturday), eight hours per day. There was no significant difference in the total number of falls between the intervention days and non-intervention days (Monday, Wednesday, and Friday). However, introducing the fall-risk manager into the long-term care facility resulted in a slight improvement in cognitive function in the residents. Although this study did not show a significant beneficial effect for fall prevention, potential effects of fall-risk reduction were noted by the intervention method through introducing a fall-risk manager in a long-term care facility.
    Download PDF (990K)
  • Motoo Kikuchi, Toshiaki Inagaki, Ryuzo Ueda
    2004 Volume 41 Issue 4 Pages 420-425
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    A 91-year-old woman was hospitalized with acute respiratory distress syndrome due to pneumonia in June 1997. Since she had pancytopenia and a bone marrow aspirate indicated hypocellularity with no increase in myeloblasts, dysplasia or abnormal chromosomes, aplastic anemia (AA) was diagnosed. Pulse therapy with methylprednisolone and antibiotics proved successful, and blood cell numbers stabilized. In June 2001, she was readmitted to our hospital with persistent low grade fever and leukopenia. A bone marrow aspirate from the sternum and iliac bone biopsy revealed compact proliferation of small lymphocytes, and the surface marker CD5- CD10- CD11c+ CD19+ CD20+ CD23- was detected through immune staining and flowcytometry. CD30+, CD34+ and CD56+ cells were scarce. Tests for surface immunoglobulins, IgG, IgA, IgM and IgD, were negative. No nodal or extranodal lesions were evident. Since Southern blot analysis of bone marrow cells indicated rearrangement of the immunoglobulin heavy chain and abnormal chromosomes were evident, small lymphocytic lymphoma (SLL) was diagnosed. Four intravenous infusions of rituximab (375mg/m2) were administered without critical adverse effects. Tests conducted four weeks later revealed saturation of CD20+ antigens of lymphoma cells and chromosomal abnormalities and rearrangement of the immunoglobulin heavy chain were still apparent. Though complete remission of the pancytopenia was not achieved, serum concentrations of lactate dehydrogenase and soluble interleukin-2 receptor decreased, and the numbers of platelets and erythrocytes increased. There was also an improvement in systemic condition. This was a rare case of SLL having the surface marker of CD5- CD10- CD11c+ CD19+ CD20+ CD23-, which had evolved from AA and infiltrated bone marrow.
    Download PDF (3165K)
  • Yayoi Koizumi, Shuichi Awata, Toru Seki, Naoki Nakaya, Shinichi Kuriya ...
    2004 Volume 41 Issue 4 Pages 426-433
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    To determine the association between social support and depression in elderly Japanese, we conducted a Comprehensive Geriatric Assessment among residents aged 70 years or over.
    Out of 2, 730 eligible subjects, 1, 179 participated in the survey and 1, 146 (480 men and 666 women) were analyzed. The Geriatric Depression Scale (GDS) was used to estimate depression status. The subjects were divided into two groups: depressive (GDS>11 or taking antidepressant drugs) and non-depressive (GDS<11). Various levels of social support were assessed by the following questions: Do you have someone (1) whom you can consult when you are in trouble? (2) whom you can consult when your physical condition is not good? (3) who can help you in daily housework? (4) who can take you to a hospital when you don't feel well? (5) who can take care of you when you are ill in bed? In multivariate logistic regression analysis, the calculated odds ratios (95% CIs) for the lack of each type of social support for depression status were: (1) 2.5 (1.5-4.1), (2) 1.9 (1.1-3.2), (3) 2.7 (1.7-4.4), (4) 1.9 (1.1-3.2), (5) 2.8 (1.6-4.9) in men, and (1) 1.2 (0.8-1.8), (2) 1.2 (0.8-1.8), (3) 1.4 (1.0-2.0), (4) 1.6 (1.1-2.3), (5) 2.0 (1.4-2.9) in women.
    A significant association was found between social support and depression in this elderly population. We also found that this association was stronger in men.
    Download PDF (1246K)
  • 2004 Volume 41 Issue 4 Pages 434-444
    Published: July 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Download PDF (2093K)
feedback
Top