Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 43 , Issue 6
Showing 1-28 articles out of 28 articles from the selected issue
  • Michiaki Mishima
    2006 Volume 43 Issue 6 Pages 667-673
    Published: November 25, 2006
    Released: March 02, 2011
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  • Makoto Kuro-o
    2006 Volume 43 Issue 6 Pages 674-681
    Published: November 25, 2006
    Released: March 02, 2011
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  • Masahiro Kanno
    2006 Volume 43 Issue 6 Pages 682-684
    Published: November 25, 2006
    Released: February 24, 2011
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  • Hiroshi Hasegawa
    2006 Volume 43 Issue 6 Pages 685-686
    Published: November 25, 2006
    Released: February 24, 2011
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  • Yoshio Wakatsuki
    2006 Volume 43 Issue 6 Pages 687-689
    Published: November 25, 2006
    Released: February 24, 2011
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  • Hideki Ito
    2006 Volume 43 Issue 6 Pages 690-692
    Published: November 25, 2006
    Released: February 24, 2011
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  • Jun Takata, Masanori Nishinaga, Yoshinori Doi
    2006 Volume 43 Issue 6 Pages 693-696
    Published: November 25, 2006
    Released: February 24, 2011
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    Although there has been great progress in reperfusion therapy, the role of coronary reperfusion for elderly patients with acute myocardial infarction has not been fully investigated. In general, mean age of the subjects in major trials was about 60 years old and approximately only 10 to 15% of patients were over age 75. On the other hand, large-scale registries such as the US national registry of myocardial infarction (NRMI) showed a higher prevalence of elderly (especially women) in the clinical setting. This discrepancy may be due to the fact that elderly patients with myocardial infarction have some difficulties in the treatment such as severe multi-vessel coronary lesions, non-cardiac complications and relatively high prevalence of adverse reactions to reperfusion therapy.
    Here we focus on the situation of elderly patients (especially those 75 years or older) with myocardial infarction in the “real world” clinical setting, showing the clinical changes and outcome of our registry in rural Japan: the Kochi AMI (KAMI) registry.
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  • Jitsuo Higaki
    2006 Volume 43 Issue 6 Pages 697-699
    Published: November 25, 2006
    Released: February 24, 2011
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  • Mitsuyoshi Namba
    2006 Volume 43 Issue 6 Pages 700-701
    Published: November 25, 2006
    Released: February 24, 2011
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  • Shinji Okubo, Akihiro Fukuda
    2006 Volume 43 Issue 6 Pages 702-705
    Published: November 25, 2006
    Released: February 24, 2011
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  • Iwao Kuwajima
    2006 Volume 43 Issue 6 Pages 706-709
    Published: November 25, 2006
    Released: February 24, 2011
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  • Kazuaki Shimamoto, Shigeyuki Saito, Tetsuji Miura
    2006 Volume 43 Issue 6 Pages 710-713
    Published: November 25, 2006
    Released: February 24, 2011
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  • Tohru Ohe
    2006 Volume 43 Issue 6 Pages 714-717
    Published: November 25, 2006
    Released: February 24, 2011
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  • Hiroyuki Yaoita, Yukio Maruyama
    2006 Volume 43 Issue 6 Pages 718-721
    Published: November 25, 2006
    Released: February 24, 2011
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    Heart failure (HF) is a major disease of the elderly. Since their symptoms of HF are generally light, on admission of the hospitals HF is sometimes in an advanced stage. Therefore, preventive medicine for those with the risk factors of HF is needed as a future strategy of cardiac gerontology. The routine assessment of the HF severity may be performed noninvasively by Nohria's profiles rather than other invasive methods. HF is worsened by the interaction with the co-morbidity factors, such as renal dysfunction and anemia. The interaction between HF and kidney disease (and anemia) is called ‘cardiorenal (anemia) syndrome.’ Recurrent hospitalization due to HF is common, and the period of hospitalization tends to be long in this syndrome. One of the hopeful therapeutic agents is carperitide, a recombinant human atrial natriuretic peptide. In cardiorenal syndrome, much lower initial doses of carperitide, such as 0.0125μg/kg/min is recommended for treatment of HF in order to avoid possible worsening of renal dysfunction. In cardiorenal anemia syndrome, supplement of iron, careful blood transfusion in severe cases, administration of recombinant human erythropoietin, should be performed if indicated. However, the possibility of anemia unrelated to HF, such as due to gastrointestinal carcinoma, is also considered in the elderly. In such cases, finding a decrease of serum ferritin preceding that of hemoglobin may contribute to a differential diagnosis of anemia in elderly HF patients. Thus, the therapies considering several features of HF in elderly will contribute to improving quality of life and outcome.
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  • Shunei Kyo, Kazuhito Imanaka, Keiko Abe
    2006 Volume 43 Issue 6 Pages 722-725
    Published: November 25, 2006
    Released: February 24, 2011
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  • Kanichi Asai, Yoichi Sakurai
    2006 Volume 43 Issue 6 Pages 726-729
    Published: November 25, 2006
    Released: February 24, 2011
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    A multidisciplinary team for bed sores consisted of 10 members including 3 dermatologists, 3 nurses, 1 physical therapist (PT), 1 pharmacist, 1 dietician, and 1 medical clerk. The incidence of new bed sores after admission was significantly decreased from 3.31% in 2003 to 1.04% in 2005 (P<0.01). A total of 324 percutaneous endoscopic gastrostomy (PEG) procedures were performed from 2001 to January 2006. Among those, the survival of 172 elderly patient (aged 65 years or older at the time of PEG) was calculated by the Kaplan-Meier method. The 30-day mortality rates was 11%, and the 1-year, and 5-year survival rates were 61.2%, and 34.4% respectively. After discharge, 40 patients were followed up at the PEG clinic in our hospital whose staff consisted of 1 expert surgeon, 5 nurses and 1 dietician. When compared with 67 patients transferred to other hospitals or nursing homes, the patients in the PEG clinic showed a significantly longer survival (P<0.01, 44 versus 29 months). A full-time integrated treatment (FIT) program for stroke rehabilitation was developed in the Nanakuri-Sanatorium of our university in 2000. Eighty-one stroke patients were on the FIT program during their hospital stay and achieved significantly higher activities of daily living (ADL) scores (P<0.01) at discharge assessed by functional independence measure (FIM) compared to 41 patients on previous rehabilitation program. In addition, their ADL scores were maintained significantly higher (P<0.05) even at 18 month after discharge, which might help them to stay home independently or with less care burden.
    These results suggest the important role of multidisciplinary approach for geriatric care and rehabilitation.
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  • Hiroshi Sumii
    2006 Volume 43 Issue 6 Pages 730-733
    Published: November 25, 2006
    Released: February 24, 2011
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    The social security system in Japan was greatly revolutionized when the long-term care insurance plan began in April 2000. Thus, Japan began the 21st century with two great social insurance plans, that is, medical care insurance and long-term care insurance. Each delivery system is divided: the medical care insurance plan is for the acute stage, and the long-term care is for the chronic stage. Both systems can be intended to cooperate to provide continuous care throughout life. The public health and welfare system has been trying hard to efficiently integrate the medical and long-term care insurance plans. However, it is necessary to establish a new insurance plan for ensuring the integrated adequacy of both insurance systems.
    One's life is destined to shift from medical care to long-term care at some point. As one ages or becomes disabled, it becomes difficult to lead an independent life with self-decision, and social support become necessary from third parties, instead of from the family or from one's own means. The society imposes the responsibility of payment of the medical and long-term care plan premiums on the individual throughout life. However, the structure of these insurance foundations should be combined under an integrated system, “Careworks”, in order to also combine the concepts of length of life from the medicine and the respect of living from the long-term case to improve the social security of the life.
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  • Kazuo Chin
    2006 Volume 43 Issue 6 Pages 734-737
    Published: November 25, 2006
    Released: February 24, 2011
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  • Shinji Teramoto
    2006 Volume 43 Issue 6 Pages 738-741
    Published: November 25, 2006
    Released: February 24, 2011
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  • Ken Shinmura
    2006 Volume 43 Issue 6 Pages 742-744
    Published: November 25, 2006
    Released: February 24, 2011
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  • Hidenori Arai
    2006 Volume 43 Issue 6 Pages 745-748
    Published: November 25, 2006
    Released: February 24, 2011
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  • Kunji Shirahama, Yasuyo Mimori, Yumiko Kaseda, Ryuji Kobayashi
    2006 Volume 43 Issue 6 Pages 749-754
    Published: November 25, 2006
    Released: February 24, 2011
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    The purpose of this study is to examine frontal lobe function of non-dementia Parkinson's disease (PD) patients. We examined the neuropsychological and behavioral evaluation (Stroop reaction time: SRT). Target image (20%) and non-target image (80%) were presented to PD patients, healthy elderly controls, and healthy young subjects at random. We instructed subjects that the button should pressed on the target image. This study was designed to investigate the mental set under three conditions.
    The Stroop test, Word Fluency Test (WFT), and Geriatric Depression Scale (GDS) were used to assess cognitive function. The SRT of PD were congruent condition and incongruent condition increased compared with simple condition. The delay of a similar SRT was seen in the healthy elderly control and young groups. However, the SRT of PD patients was slower under incongruent condition than under congruent condition. It appears that PD spent time on judgment in under incongruent condition because the meaning of the character did not correspond to the color of the character. Because, there were no significant between PD and healthy elderly subjects in Stroop test, WFT, and GDS, frontal lobe function had a partial deficit. The SRT of PD was increased by the partial deficit in information processing ability in addition to movement dysfunction.
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  • Tsuyoshi Yoshida, Yasushi Uchiyama
    2006 Volume 43 Issue 6 Pages 755-760
    Published: November 25, 2006
    Released: February 24, 2011
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    Aim: To clarify the clinical features of physical therapy for motor dysphagia by identifying changes in indices when swal-lowing function changes.
    Method: Subjects comprised 59 stroke patients with motor dysphagia. They were subdivided into 3 groups according to changes in swallowing function (Group A: improved, Group B: deteriorated, Group C: unchanged). Measured indices for swallowing movement consisted of 4 items; distance from the genion to the thyroid cartilage (GT), distance from the thyroid cartilage to the sternum (TS), relative thyroid position (GT/(GT+TS)), and strength of the suprahyoid muscles (GS grade). Measured indices for neck-trunk function consisted of the passive neck range of motion in 4 directions (flexion, extension, lateral flexion, and rotation), and neck-trunk-pelvis stage (NTP stage) as described by Yoshio. Measured indices for swallowing function were the repetitive saliva swallowing test, the modified water swallowing test, the food test, and Saitoh's classification of dysphagia.
    Results: Group A consisted of 30 patients (mean age, 68.1 years), Group B consisted of 6 patients (mean age, 78.7 years), Group C consisted of 23 patients (mean age, 73.0 years). Group A exhibited significant improvements in GS grade, NTP stage, neck extension and rotation. In Group B, only relative thyroid position was affected. In Group C, no changes were evident.
    Conclusion: To obtain improved swallowing function, approaches aimed at both local function of swallowing muscles and neck-trunk function should be used. Preventing deterioration of swallowing function requires attention to thyroid position affected by inappropriate posture.
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  • Yasuko Inaba, Shuichi Obuchi, Koichiro Oka, Takeshi Arai, Hiroshi Naga ...
    2006 Volume 43 Issue 6 Pages 761-768
    Published: November 25, 2006
    Released: February 24, 2011
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    Aim: The purpose of the present study was to 1) development the scale of the self-efficacy of physical activity in frail elderly people (SEPAF), 2) investigate the relationship of physical functions and instrumental activity of daily living (IADL).
    Methods: The study included 187 community-dwelling elderly people. Subject's SEPAF (walking, stair-climbing, lifting a weight), physical functions (usual gait speed, maximum gait speed, knee extension muscle strength, hand grip) and IADL according to the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG Index of Competence) were measured. The reliability of this scale was examined using Cronbach's α, and test-retest correlation. The criterion-related validity and the construct validity were evaluated relatively using physical functions and factor analysis. The score was compared between young-old and old-old and gender. The correlation between SEPAF and TMIG Index of Competence was examined.
    Results: Cronbach's α showing internal consistency for these scales were 0.78-0.82. The score showed significant differences in gender and age group. There were significant relationships between SEPAF and physical functions, and the TMIG Index of Competence.
    Conclusion: The SEPAF was shown to be highly reliable. Few scale for frail elderly people exist, and it is useful to assess the self-efficacy of physical activities in frail and community-dwelling elderly people.
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  • Tomoyuki Tsujikawa, Katsuyuki Kitoh, Akira Andoh, Masaya Sasaki, Shige ...
    2006 Volume 43 Issue 6 Pages 769-772
    Published: November 25, 2006
    Released: February 24, 2011
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    Aim: Ulcerative colitis (UC) primarily affects young adults, but the proportion of elderly patients with UC seems to be increasing. It is important that the clinical characteristics of elderly patients be analyzed.
    Methods: In the older group consisted of 32 outpatients (23 aged 50-64 years old, 9 aged 65 or over) in our hospital, we evaluated disease duration, severity, therapeutic efficacy and other clinical problems.
    Results: The age distributions of the disease onset showed a peak at early age and decreased with aging. The degree of severity was mainly mild, and left-sided or pancolitis were more frequent than expected in the older group. Most elderly patients suffered other diseases, and care was required in the administration of steroids.
    Conclusion: The clinical features of elderly patients with UC were similar to those of younger patients. However, It should be considered that elderly patients often have complications requiring care in the use of steroids.
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  • Hajime Iwasa, Takao Suzuki, Yuko Yoshida, Jinhee Kwon, Hideyo Yoshida, ...
    2006 Volume 43 Issue 6 Pages 773-780
    Published: November 25, 2006
    Released: February 24, 2011
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    Purpose: We explored correlates of change in cognitive function during a two-year follow-up period among the community-dwelling elderly in Japan, using a population-based prospective approach.
    Method: The participants analyzed in the present study were 260 men and 222 women aged 70 to 84 years at baseline, living in an urban Japanese community. Data such as change in cognitive function during two years (calculated by subtracting baseline Mini-Mental State Examination [MMSE] score from follow-up MMSE score: a negative value means a decrease in MMSE scores during the two-year period) as an outcome variable, age, education, hearing and vision problems, IADL deficit (measured by the Tokyo Metropolitan Institute of Gerontology of Index of Competence), problems related to memory complaint, living alone, hemoglobin level, as explanatory variables, and the baseline MMSE score, depressive status (measured by the Mini-International Neuropsychiatric Interview), chronic conditions (hypertension, stroke, and diabetes mellitus) as covariates, were collected during a comprehensive health examination survey for the elderly.
    Results and Conclusion: We conducted multivariate regression analysis by genders to explore correlates of change in cognitive function. The results showed that higher age (β=-0.18), presence of hearing problem (β=-0.21), presence of IADL deficit (β=-0.15), and memory complaint (β=-0.20) in men, and higher age (β=-0.27), low education level (β=-0.25) and lower hemoglobin level (β=0.16) in women, were significantly associated with change in cognitive function when adjusting for the potential confounders. These factors may be reliable predictors for cognitive decline.
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  • Takeshi Arai, Shuichi Obuchi, Motonaga Kojima, Yuko Matumoto, Yasuko I ...
    2006 Volume 43 Issue 6 Pages 781-788
    Published: November 25, 2006
    Released: February 24, 2011
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    Aim: It is necessary to determine the effect of exercise on each individual in order to target a person for an exercise regimen intended to prevent specific health defects in the elderly. The purpose of this study was to evaluate the relationship between physical conditions and changes in functional measurements after exercise intervention.
    Methods: Two hundred seventy-six subjects aged 60 years and older practiced exercise intervention for three months. The measurements were maximal walking speed, one-leg standing with eyes opened or closed, functional reach test, timed up and go test, sit and reach, handgrip strength, and knee extensor strength. We evaluated the associations between physical measurements and changes in functional measurements.
    Results: Except for one-leg standing with eyes closed, all measurements of physical function were significantly improved after exercise intervention. The changes in functional measurements showed significant negative correlations with the initial physical performance measurements, except for maximal walking velocity.
    Conclusions: These results provided valuable information on more effective strategies for improving or maintaining physical functions of community-dwelling older people. Comprehensive approaches that adapt the methods of training to the fitness level of each subject are needed to effectively improve the physical function of older people.
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  • 2006 Volume 43 Issue 6 Pages 789-796
    Published: November 25, 2006
    Released: February 24, 2011
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