Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
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Volume 48, Issue 1
Displaying 1-19 of 19 articles from this issue
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The 52nd Annual Meeting of the Japan Geriatrics Society: Presidential Adress
The 52st Annual Meeting of the Japan Geriatrics Society: Meet the Expart 2: The point of medical care for the aged
The 52nd Annual Meeting of the Japan Geriatrics Society: Meet the Expart 3: Intervention in the lifestyle-related diseases
The 52nd Annual Meeting of the Japan Geriatrics Society: Panel Discussion 2: Fall of the elderly -pathogenesis and the strategy for prevention
The 52nd Annual Meeting of the Japan Geriatrics Society: Young Investigator's Symposium 2: Sarcopenia -mechanism, diagnosis and prevention
Original Articles
  • Clinical characteristics of ischemic stroke in elderly patients with cancer
    Tomoyuki Kono, Toshiho Ohtsuki, Naohisa Hosomi, Ikuko Takeda, Shiro Ao ...
    2011 Volume 48 Issue 1 Pages 57-62
    Published: 2011
    Released on J-STAGE: March 03, 2011
    DOIhttps://doi.org/10.3143/geriatrics.48.57
    JOURNAL FREE ACCESS
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    Aim: We classified acute ischemic stroke patients with cancer according to their causal relations, and attempted to evaluate the clinical characteristics of ischemic stroke associated with cancer.
    Methods: This is a retrospective study of all acute ischemic stroke patients admitted to our hospital between January 2006 and March 2009. Among acute ischemic stroke patients, we identified 30 patients with a history of cancer, or who developed cancer within 1 year from their ischemic stroke onset. There were 2 patients excluded from our evaluation because they had undergone extirpation of their cancer more than 5 years before stroke onset, and no recurrence of cancer within 5 years of stroke onset was noted. Finally, 28 patients were enrolled and evaluated in this study. Ischemic stroke was classified based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. In addition, we classified the patients according to their causal relations of ischemic stroke with cancer.
    Results: The median patient age was 74 years (range, 56 to 91 years); 68% of patients were men. Of these, 8 (29%) were classified into an ischemic stroke related to cancer group. There was a higher prevalence of ischemic stroke related to cancer in patients under 75 years old with clinical stage IV cancer (p=0.02). D-dimer tended to be higher in those patients with ischemic stroke related to cancer in this study (p=0.13).
    Conclusion: Ischemic stroke related to cancer was found more frequently in patients under 75 years old with advanced cancer. Additionally, D-dimer tended to be higher in those patients with ischemic stroke related to cancer.
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  • Comprehensive intervention for the management of elderly patients with aspiration pneumonia
    Masahisa Arahata, Masato Kuriyama, Hiroshi Yoneyama, Shinji Minami
    2011 Volume 48 Issue 1 Pages 63-70
    Published: 2011
    Released on J-STAGE: March 03, 2011
    DOIhttps://doi.org/10.3143/geriatrics.48.63
    JOURNAL FREE ACCESS
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    Aim: Comprehensive management, including medical treatment, care and nursing, rehabilitation, and nutrition management is essential for elderly patients with aspiration pneumonia. We designed and attempted a unique comprehensive intervention method for aspiration pneumonia, and analyzed whether it could improve their prognosis.
    Methods: The subjects were patients aged 75 years or more, in whom aspiration pneumonia had been diagnosed between January 15th and April 15th, 2008. Immediately after diagnosis, our project team analyzed the pathophysiology of each case based on the checklists and conference records, and planned an individualized strategy of comprehensive intervention. We analyzed their mortality due to pneumonia, duration of their hospitalization and recurrence-free survival 1 year after antibiotic therapy (1-year RFS), and compared them with those of patients who were managed without antibiotic intervention during the same period in the previous year.
    Results: There were 41 events in 34 patients (15 men, 19 women, age 87.5±5.7) which were eligible for analysis as an intervention group and 51 events in 46 patients (24 men, 22 women, age 87.5±6.4) were eligible as a control group (age 87.5±6.4). Our comprehensive intervention tended to reduce aspiration pneumonia mortality (4.9% vs. 17.6%, P=0.061). There was no significant difference in the duration of hospitalization between the 2 groups (47.2±35.0 days vs. 55.6±52.1 days, P=0.454). The 1-year RFS of the intervention group was significantly higher than that of the control group (48.5% vs. 24.3%, P=0.040).
    Conclusions: Our comprehensive intervention for the management of elderly patients with aspiration pneumonia achieved a significant improvement in 1-year RFS.
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  • Comparison of the effect of abdominal obesity on new onset of type 2 diabetes in a general Japanese elderly population with that in a non-elderly population-The Tanno and Sobetsu study
    Mizue Fujii, Hirofumi Ohnishi, Shigeyuki Saitho, Mitsuru Mori, Kazuaki ...
    2011 Volume 48 Issue 1 Pages 71-77
    Published: 2011
    Released on J-STAGE: March 03, 2011
    DOIhttps://doi.org/10.3143/geriatrics.48.71
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    Aim: We investigated the effect of abdominal obesity (AO) on new onset of type 2 diabetes (NODM) in a general Japanese elderly population compared with that in a non-elderly population.
    Methods: The subjects were 827 people aged 29-84 who underwent medical examinations in the towns of Tanno and Sobetsu in Hokkaido, first in 1994 and subsequently in either 2003 or 2004, after the exclusion of individuals with preexisting type 2 diabetes at baseline. The subjects were divided into 2 groups according to waist circumference (WC) at baseline: an AO (WC ≥85 cm for men and ≥90 cm for women) group and a non-AO group. The percentages of subjects with NODM recorded in either in 2003 or 2004 were compared between these 2 groups, and the AO odds ratio in NODM was calculated separately for elderly (≥65 years) and non-elderly (<65 years) subjects, using multiple logistic regression analysis.
    Results: The percentage of non-elderly subjects with NODM was significantly higher in the AO group than in the non-AO group (16.9% vs. 5.4%, p<0.0001), but there was no statistically significant difference in the elderly subjects. Multiple logistic regression analysis showed that there was a significant relationship between AO and NODM (AO odds ratio in NODM=2.68, 95% confidence interval (CI): 1.05-6.90) in the non-elderly subjects, but not in the elderly subjects.
    Conclusion: Consideration of the different effects of AO on NODM in elderly and non-elderly people may be important for the prevention of type 2 diabetes.
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Case Report
  • A ten-year follow-up of a 109-year-old woman with myocardial infarction
    Hidetomo Maruyoshi, Takashi Baba, Jiro Ogata, Soichi Nagata
    2011 Volume 48 Issue 1 Pages 78-83
    Published: 2011
    Released on J-STAGE: March 03, 2011
    DOIhttps://doi.org/10.3143/geriatrics.48.78
    JOURNAL FREE ACCESS
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    A 109-year-old woman was hospitalized with myocardial infarction in the geriatric long-term care ward of our hospital. Her medical history was unknown, and she was receiving only peroral 20 mg/day furosemide. Her medical records at another hospital revealed that she had been given a previous diagnosis of myocardial infarction of the anteroseptal wall of the left ventricle by a cardiovascular specialist approximately 10 years previously. Although treatment with cardiovascular drugs such as an angiotensin II receptor blocker, aspirin, and spironolactone had been started, it was discontinued because of her hospital transfer and change in her attending physician. Because of aggravation of the symptoms of cardiac failure caused by infection, treatment with the angiotensin-converting enzyme inhibitor temocapril (1 mg/day), spironolactone (12.5 mg/day), aspirin (100 mg/day), and a beta-adrenoceptor blocker carvedilol (2 mg/day) was tentatively initiated. Consequently, her B-type natriuretic peptide (BNP) level improved and her condition stabilized. She finally died of old age. Both inappropriate sharing of patient information among medical facilities and restrictions on medical care in Japanese health care system for the elderly may lead to improper and/or inadequate medical treatment for elderly patients. Although little evidence is available to support medical care for centenarians, treatment which is based on a thorough understanding of their physiological characteristics enables us to improve their quality of life.
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Short Report
Letters to the Editor
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