Tai chi improves cognitive and physical function in the elderly: a randomized controlled trial.

[Purpose] To investigate the effect of Tai Chi on cognitive and physical function in the elderly. [Subjects and Methods] A randomized trial design was used. A total 150 subjects were enrolled and were divided into Tai Chi and control groups. Subjects in the Tai Chi group participated Tai Chi for 6 months, and subjects in the control group participated in other non-athletic activities. [Results] There were no differences between the groups in the one leg standing time with eyes open, left grip strength, or the Frontal Assessment Battery at bedside after 3 and 6 months of intervention. The Mini-Mental State Examination scores after 3 and 6 months were higher in the Tai Chi group than in the control group. The right grip strength after 3 months increased more in the Tai Chi group than in the control group. Both the 5-m high walking speed and 10-m normal walking speed were significantly lower after 3 and 6 months of Tai Chi practice. [Conclusion] These results suggest that regular Tai Chi practice may improve cognitive and physical function in the elderly.

[The current situation of older hospitalized patients in a cadre ward in Jilin, China].

OBJECTIVE: The proportion of elderly people and the nation's medical expenditures are rapidly increasing in China. The existence of cadre wards, where retired members of the cadre of the Communist Party of China are hospitalized and receive careful treatment, helps in providing care for the elderly. Elderly retired cadre patients are thought to be more frequently hospitalized and to stay in the hospital longer than elderly non-cadre patients on general hospital wards, and therefore might be expected make an important contribution to the increase in the nation's medical expenditures. However the current situation is not well characterized. The aim of this study was to provide a basis for possible solutions related to the cadre patient burden by determining the circumstances and background of these patients with long hospital stays and investigating their needs. METHODS: We analyzed the medical records of hospital discharges from a cadre ward from 2000 to 2004, and from general wards in 2004 at a large university-affiliated hospital in Jilin, China. Additionally, a questionnaire survey including an interview concerning needs was carried out in August 2005 for 100 elderly patients on the cadre ward (91% of the total patients on this ward) of the same hospital at that time. RESULTS: The mean length of hospital stays of patients on the cadre ward decreased by half during the study period, but remained longer than that of patients on general hospital wards. Regression analysis showed that of all the variables measured, the type of ward (cadre vs. general) was the most influential on the mean length of hospital stay. Moreover, patients who were hospitalized more often, males and older individuals showed longer hospital stays. The questionnaire survey showed that there are many patients who could be discharged from the hospital based on their health condition but are not discharged because outside care or welfare services are insufficient, or because there is little information available on social resources. CONCLUSIONS: Although medical policy, by which elderly retired cadre patients receive careful treatment, may contribute to the longer length of the hospital stay of the patients on the cadre ward, it was thought to be important to construct appropriate discharge plans and a support system after discharge to the community. The results provide important information for solution of medical problems related to elderly retired cadre patients in China.

[Effects of home visitation by nurses around one month after delivery focus on mother's anxiety and awareness of child rearing problems].

PURPOSE: We evaluated the effects of home visitation by nurses around one month after delivery, focusing on mother's anxiety and awareness of child rearing problems. METHOD: We selected mothers who had a normal first child, and assigned them to the intervention (n = 131) or control (n = 100) groups. For the former, home visits were made by nurses, and for the controls, the usual care was provided. Outcome measurements were conducted before the intervention (Time I) and two months after (Time II). Usual care (neonatal home visiting service) was commonly provided by city health department, but not all subjects received a visit. We excepted the subjects who were provided with this usual care, analyzing the remaining subjects in the two groups. RESULTS: The eligible subjects of the intervention group were 64 mothers (48.9%) and in the control group were 66 mothers (66%). There were no significant difference in terms of Time I demographic characteristics and outcome measures between two groups. However, there were significant differences in outcomes (mother's anxiety and awareness) between the two groups by ANCOVA, the intervention group showed decline of anxiety (P = 0.04) and improved enjoyment of child rearing (P = 0.02). Almost all mothers of the intervention group expressed the opinion that home visits by nurses were useful for themselves. CONCLUSION: We suggest that nurse home visitation around one month after delivery is useful to provide formal support for mother childcare.

Changes in functional capacity in older adults living alone: a three-year longitudinal study in a rural area of Japan.

OBJECTIVE: The purposes of this research were to clarify three-year changes in functional capacity and to investigate related physical health, psychological/mental health, and social health factors in older adults living alone in a rural area of Japan. METHODS: Home visit interviews were conducted in 2000 (the baseline survey: n = 128) and in 2003 (the follow-up survey: n = 101) with older adults living alone in a town in Ishikawa prefecture. Seventy nine subjects were analyzed using logistic regression analysis at the follow-up survey. RESULTS: Of these 79 subjects, 40 persons had scores for functional capacity decreased by one or more points, the "Lowered" group (50.6%), while 27 persons were "Unchanged" (34.2%), and 12 persons were "Improved" (15.2%). Factors at the baseline survey were compared between the "Lowered" group and the "Unchanged/Improved" group. Significant factors that caused a decreased functional capacity were age (75 years old and over), no participation in social activities, and contact with friends/neighbors over the phone less than once a week. CONCLUSION: This research has shown that participation in social activities and contact with friends/neighbors maintain a higher functional capacity in older adults living alone.

[Evaluation of a community-based preventive care program for elderly living at home].

PURPOSE: The purpose of this study was to evaluate a community-based preventive care program focused on physical and psychosocial status of frail elderly living at home. METHOD: The study had a prospective cohort design. Community-dwelling frail elderly not applying for the long-term insurance system care were assigned to a participant group (n = 71), wishing to participate in the community-based preventive care program, and a non-participant group (n = 40) who did not have the intention. The care program included activities and health education for elderly to promote their social contacts. Outcome variables were Activities of Daily Living (FIM), upper extremity function, time required for a 1.5 meter walk, health complaints, cognitive function (MMSE), psychological Quality of Life (QOL), depression (GDS), modified fall-related self efficacy (MFES), self efficacy for health promotion (SEHP), and social network. Data were collected prior to and at 6 months and 12 months after the intervention. RESULTS: 1. At the baseline, the number of female (P = .033) and B day service use (P = .001) in the participant group was significantly greater, and the number reporting falls (P = .017) and A day service use (P = .014) was lower than the non-participant group. MMSE (P = .032), MFES (P = .001), and SEHP scores (P = .017) as well as the social network values (P = .022) in the participant group were significantly higher than for the non-participant group. 2. The participants demonstrated significant effectiveness in the MMSE scores (P = .002) during the follow-up period, values after both 6-months (P = .002) and 12-months (P = .005) follow-up, being lower than in the non-participant group. 3. The participant group also demonstrated significant effectiveness in the GDS score (P = .033) during the study period, their values being lower after 12-months (P = .070) than in the other group. CONCLUSION: The results indicated that the community-based preventive care program to the elderly could effect on cognitive function and depression.

[Cardiovascular responses during bed-to-wheelchair transfers in frail elderly subjects living at home].

Cardiovascular responses during bed-to-wheelchair transfers were measured in 22 frail elderly subjects (mean age, 79.7 years) and 11 healthy elderly subjects (mean age, 79.8 years) living at home. The frail elderly subjects were divided into two groups, based on the method of transfer: the dependent group consisted of 11 subjects who required additional help during all stages of the transfer, and the partially dependent or independent group consisted of 11 subjects who could perform the transfer with some help or independently. In the healthy elderly subjects, diastolic blood pressure increased significantly 15 minutes after the transfer compared to the pre-transfer measurement (p < 0.05). In the dependent group, there was no significant change in blood pressure, and mean blood pressure (MBP) decreased gradually after the transfer in 3 subjects. Only 4 subjects exhibited a normal change in heart rate variability after the transfer. These results suggest the existence of poor cardiovascular responsiveness in most of these subjects. In the partially dependent or independent group, there was a significant increase in blood pressure just after the transfer (p < 0.05), in 3 subjects, the blood pressure reached the WHO's defined hypertension threshold (SBP > 160 mmHg or DBP > 95 mmHg). In these subjects, performing the bed-to-wheelchair transfer independently may result in cardiac overload. The change in MBP in the dependent group was significantly lower than that of the partially dependent or independent group from just before the transfer to 15 minutes after the transfer (p < 0.05). Blood pressure responses during bed-to-wheelchair transfers in frail elderly subjects living at home may differ according to the method of transfer.

Social support as a predictor of health status among older adults living alone in Japan.

The purpose of this study was to determine social support as a predictor of health status among older adults living alone, based on a 2-year longitudinal study in a rural area of Japan. The self-reported questionnaires were distributed to 624 older adults living alone and were collected during home visits by welfare commissioners as baseline survey. After the follow-up survey of 493 respondents as the baseline survey, we analyzed 340 persons who lived alone over the last 2 years. Women had significantly higher emotional and instrumental support scores than men. Receiving positive support from the neighborhood had a significant effect on retaining activities of daily living for older women living alone. Our results suggest that receiving social support from the neighborhood brought an improvement in the health status of older adults, particularly women living alone.