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Objective:To systematically evaluate the dose-response relationships of resistance exercise intensity in frail elderly.Methods:A comprehensive search of randomized controlled trials on the dose-response relationships of resistance exercise for frail elderly in PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database. The documents that met the conditions were screened out, and after the data were extracted and the quality of the documents were evaluated, the RevMan 5.3 software was used for Meta analysis.Results:A total of 10 eligible randomized controlled trials were included in this study. The subjects of the study were 454 cases of frail and pre-frail elderly. After Meta analysis, there was a dose-response relationships between the training intensity of resistance exercise and the muscle strength, muscle endurance, and physical function of frail elderly. Both low-intensity and high-intensity resistance exercises can significantly increase the leg muscle strength of frail elderly people ( MD=4.58, 95% CI 3.34-5.82, P<0.05) and muscle endurance ( MD=12.27, 95% CI 6.54-17.99, P<0.05). Compared with low-intensity resistance exercise, high-intensity resistance exercise increased leg muscle strength of frail elderly people ( MD=7.97, 95% CI 0.85-15.09, P<0.05) and muscle endurance ( MD=6.94, 95% CI 5.21-8.66, P<0.05) showed more obvious advantages. The analysis of the results of the chair sitting test and the stairs climbing test shows that low-intensity resistance exercise has no obvious advantage in improving the physical function of frail elderly people, while high-intensity resistance exercise can significantly improve the physical function of frail elderly people ( MD=-5.8, 95% CI -7.3--4.29, P<0.05; MD=-1.20, 95% CI-2.17--0.23, P<0.05). Conclusions:Resistance exercise can significantly improve the muscle strength, muscle endurance and physical function of the frail elderly. High-intensity resistance exercise is more effective than low-intensity resistance exercise.
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Objective:To explore the effect of nurse-led multi-disciplinary team management on postoperative gastrointestinal function and nutritional status in elderly colon cancer inpatients.Methods:A total of 75 elderly inpatients after colon cancer operation who met eligibility criteria and signed informed consent form were randomized into study (n=37) or control group (n=38), receiving nurse-led multi-disciplinary team management or routine nursing for 6 months, respectively. The gastrointestinal function, days of postoperative hospital stay, body weight, body composition and dietary intake were compared between the two groups.Result:Compared to the control group, time to defecation (t=14.79, P<0.01), time to initiation of liquid diet intake (t=6.80, P<0.01), time to initiation of semi-liquid diet intake (t=10.78, P<0.01) and days of postoperative hospital stay (t=8.76, P<0.01) in the study group were significantly shortened; and body weight [(59.44±6.12)kg vs. (62.54±6.41)kg, P=0.004], BMI [(19.02±4.13)kg/m 2 vs. (19.98±3.98)kg/m 2, P=0.025], body fat percentage [(20.03±3.55)% vs. (21.34±3.68)%, P<0.01], lean body mass [(19.63±3.44)kg vs. (21.45±3.16)kg, P<0.01], grip strength [(21.65 ± 3.56) kg vs. (22.48 ± 3.81) kg, P=0.011], attainment rate of 75% target energy intake (65.8% vs. 86.5%, P=0.036) and attainment rate of 75% target protein intake (57.9% vs. 83.8%, P=0.014) were significantly improved in study group 6 months after operation. Conclusion:The nurse-led multi-disciplinary team management can effectively improve the postoperative recovery of gastrointestinal function and the long-term nutritional status in elderly patients with colon cancer.
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Objective:To investigate the effects of nurse-led interRAI-based multidisciplinary team management on body composition and metabolic parameters among elderly patients with metabolic syndrome.Methods:100 elderly patients aged 60-74 with the diagnosis of metabolic syndrome were randomized into control group ( n=50) and study group ( n=50). The control group was followed up after routine physical examination. Based on interRAI assessment, the study group received nurse-led individualized intervention which integrated management regarding geriatric internal medicine, clinical nutrition, psychology and physical rehabilitation. This 12-week study measured body composition indexes body protein, body fat mass (BFM), skeletal muscle mass (SMM), body mass index (BMI), waist-to-hip ratio (WHR) and biochemical indexes [triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin (HbA1c)] on the first day and 12 weeks after enrollment and compared those parameters between the two groups. Results:After 12 weeks of intervention, compared with the control group, the study group showed significantly increased body protein [(10.48±2.02) kg vs (9.72±1.65) kg, P=0.043], SMM [(29.61±6.07) kg vs (27.36±4.96) kg, P=0.046], BFM [(17.86±3.42) kg vs (19.64±5.07)kg, P=0.042], WHR (0.88±0.05 vs 0.89±0.03, P=0.021) and TG [(2.31±0.42) mmol/L vs (2.95±0.52) mmol/L, P=0.014]. There was no significant difference in BMI [(25.06±3.41) kg/m 2vs (24.40±2.48) kg/m 2, P=0.272], HDL-C [(0.94±0.10) mmol/L vs (0.91±0.31) mmol/L, P=0.246] and HbA1c [(6.11±0.51)% vs (6.37±0.42)%, P=0.185]. After 12 weeks of intervention, body fat [(17.86±3.42) kg vs (20.71±5.98) kg, P=0.004], WHR (0.88±0.05 vs 0.91±0.05, P=0.001), TG [(2.30±0.42)mmol/L vs (2.75±0.37) mmol/L, P=0.032] and HbA1c [(6.11±0.51) mmol/L vs (6.35±0.63) mmol/L, P=0.015] in the study group were significantly lower compared with baseline and there was no difference in those parameters at baseline and 12 weeks after enrollment in the control group. Conclusion:The nurse-led multidisciplinary management model based on interRAI assessment can effectively improve the body composition and certain metabolic indexes of the elderly with metabolic syndrome.
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Objective:To investigate the prevalence of nutritional risk and application of nutritional support among elderly hospitalized patients.Methods:Elderly hospitalized patients from Peking Union Medical College Hospital (PUMCH) were consecutively enrolled from Feb 2016 to Feb 2019. Nutritional risk was measured by using nutritional risk screening 2002 (NRS-2002) within the first 24h after admission. Body weight (BW), body mass index (BMI), grip strength (GS), lean body mass (LBM), body fat (BF) and dietary intake were measured and compared between the patients at risk and not at-risk. Nutritional support was evaluated on 14th day of admission or the discharge day. The relationship between nutritional risk and nutrition support was analyzed.Results:A total of 428 elderly hospitalized patients who met entry criteria and obtained informed consent were consecutively enrolled. The prevalence of nutritional risk (NRS score≥3) was 57.9% (248/428), and it increased significantly with age ( χ2 value was 39.11, P<0.05). Compared to not at-risk group, body weight ( t value was 3.405, P<0.01) , BMI ( t value was 2.715, P<0.05) , GS ( t value was -0.975, P<0.05) , BF% ( t value was 2.934, P<0.05) , LBM ( t value was 1.570, P<0.05) , 75% target energy intake ( χ2 value was 22.55, P<0.01)and 75% target protein intake ( χ2 value was 25.91, P<0.01) were significantly decreased in those of at risk group. There were 62.5% patients at nutritional risk and 19.7% not at-risk which received nutrition support. The average ratio of EN and PN was 1.0∶0.6. Conclusions:NRS-2002 might be used for nutritional screening among elderly inpatients. A large proportion of elderly inpatients were at nutritional risk. The nutritional status of elderly patients in different disease states is different, which deserves attention. The application of EN and PN was some inappropriate in these inpatients, and evidence-based nutritional support guideline is needed to improve this situation.
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Objective@#To investigate the status of frailty in elderly inpatients with type 2 diabetes and its influencing factors.@*Methods@#Collected 126 cases hospitalized elderly patients with type 2 diabetes (from September 2017 to August 2018) general information, glycosylated hemoglobin A1C (HbA1C), comorbidity, nutritional assessment, Mini-Mental State Examination (MMSE), the frailty scale, multiariable Logistic regression was used for the analysis of frailty influence factors.@*Results@#38.1% (48/126) of elderly in patients with diabetes had no frailty, 25.4% (32/126) of patients with pre-frailty, and 36.5% (46/126) of patients with frailty. Logistic regression analysis showed that poor nutritional status, cognitive impairment and lower scores of instrumental daily living ability were the main risk factors for frailty in elderly diabetes.@*Conclusion@#Among elderly in patients with diabetes, the incidence of frailty is high, suggesting that clinical medical staff should identify frailty patients as early as possible, strengthen the integrated management of elderly in patients with diabetes through the multidisciplinary cooperation model, provide individualized guidance, reduce and delay the occurrence of frailty in elderly patients with diabetes.
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Objective To investigate the status of frailty in elderly inpatients with type 2 diabetes and its influencing factors. Methods Collected 126 cases hospitalized elderly patients with type 2 diabetes (from September 2017 to August 2018) general information, glycosylated hemoglobin A1C (HbA1C), comorbidity, nutritional assessment,Mini-Mental State Examination (MMSE), the frailty scale , multiariable Logistic regression was used for the analysis of frailty influence factors. Results 38.1% (48/126) of elderly in patients with diabetes had no frailty, 25.4% (32/126) of patients with pre-frailty, and 36.5% (46/126) of patients with frailty. Logistic regression analysis showed that poor nutritional status, cognitive impairment and lower scores of instrumental daily living ability were the main risk factors for frailty in elderly diabetes. Conclusion Among elderly in patients with diabetes, the incidence of frailty is high, suggesting that clinical medical staff should identify frailty patients as early as possible, strengthen the integrated management of elderly in patients with diabetes through the multidisciplinary cooperation model, provide individualized guidance, reduce and delay the occurrence of frailty in elderly patients with diabetes.
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Objective To investigate the correlation between nutritional status in elderly patients with Alzheimer disease (AD) and self-efficacy of their caregivers.Methods Ninety-two elderly patients with AD and 92 their caregivers were enrolled from a Peking Union Medical College in Beijing from March to October 2017,who were evaluated by the mini nutritional assessment short form (MNA-SF) and the general self-efficacy scale (GSES) respectively for the nutritional status of the AD patients and the self-efficacy of their caregivers,and the correlation between them was analyzed.Results The average MNA-SF score of the AD patients was 7.8± 2.5.The incidence of malnutrition risk and malnutrition were 34.8％ and 27.2％ respectively.The MNA-SF score of the AD patients decreased (F =4.589,P =0.009),and the incidence of malnutrition risk (x2 =7.319,P =0.026) and malnutrition (x2 =7.080,P =0.032) increased significantly with the aggravation of AD.The average self-efficacy score of the caregivers was 2.20±0.45.With the aggravation of AD,the GSES score of the caregivers decreased significantly (F=3.122,P=0.016).There was a positive correlation between the nutritional status of the AD patients and the self-efficacy of their caregivers (r =0.254,P =0.022).Conclusion The nutritional status in elderly patients with AD is positively correlated with the self-efficacy of their caregivers,that is,the higher GSES score of the caregiver is,the better nutritional status of the AD patient has.
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Objective To explore the effect of nurse-led intensive nutritional intervention on nutritional risk,undernutrition and quality of life in hospitalized Alzheimer disease (AD) patients.Methods A total of 170 hospitalized AD patients who met the criteria of the protocol were enrolled and divided randomly into two groups as study group (n=86) and control group (n=84).The two groups received nurse-led intensive nutritional intervention and routine nutritional management respectively for six weeks.Nutritional risk,undernutrition and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and quality of life-Alzheimer disease scale before and after the nutritional intervention.Results There was no significant difference in baseline data between the two groups.The suitable rate of NRS 2002 was 100％.After a 6-week intervention,the prevalence of nutritional risk (41.9％ vs.70.9％,P＜0.001) and undernutrition (17.4％ vs.30.2％,P =0.049) decreased significantly in study group.The prevalence of nutritional risk was significantly lower in study group than in control group (41.9％ vs.64.3％,P=0.003).The score of quality of life in study group significantly increased (34.12±5.91 vs.31.56±6.80,P=0.028) after the intervention,and was significantly higher than that of the control group (34.12±5.91 vs.31.63± 6.22,P=0.030).Conclusion The application of nurse-led intensive nutritional intervention can help to improve the nutritional status and quality of life in hospitalized AD patients.
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Objective To evaluate the effectiveness of family-centered educational intervention on fall prevention knowledge and attitude,compliance and fall incidence of elderly inpatients. Methods A total of 300 elderly inpatients were selected in a first-class grade A hospital in Beijing and divided into the experiment group and the control group equally.The intervention group was given family-centered educational intervention for 6 months,while the control group was given conventional treatment and care in ward.The knowledge and attitude,compliance and the incidence of falls of elderly inpatients were evaluated at discharge and 3 months,6 months after discharge. Results The knowledge and attitude, compliance of elderly inpatients in the intervention group were significantly better than that in the control group (P<0.05).The incidence of falls in the intervention group was significantly lower than that in the control group at discharge and 3 months,6 months after discharge (P<0.05). Conclusions The family-centered educational intervention can enhance the fall prevention knowledge, attitude and compliance of elderly inpatients effectively and reduce the incidence rate of falls.The long-term effect is relatively obvious.
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Objective To investigate the effect of resistance training on the rehabilitation of hand joint in patients with rheumatoid arthritis. Methods Selecting 66 cases of the stable phase of rheumatoid arthritis (ra) patients in a rheumatoid immunology outpatient of a general hospital in Beijing during October 2016 to March 2017 ,33 patients were randomly divided into control group and 33 patients into intervention group by using random number. Exercise instruction of routine finger operation in control group;The intervention group was guided by trained nurses with finger exercises and resistance training. Two groups of patients were tested before and after 3 months of exercise, and both hands were tested and the patients were recorded with their hands. The patients were evaluated by the Signals of Functional Impairment(SOFI). Results Before exercise, the grip strength, morning stiffness time, SOFI score in the control group were:60.0(43.0,100.5) mmHg(1 mmHg=0.133 kPa), 45.0(30.0,60.0)min,2.0(1.0,3.0),and in the intervention group they were:85.0(49.3,108.7) mmHg,45.0(30.0,60.0) min,2.0(1.0,3.0),the differences between two groups of had no statistical significance (Z=-1.488,-0.609,-0.118, P>0.05). After three months of exercise, the grip strength, morning stiffness time, SOFI score in the control group were:60.0 (40.5,102.7) mmHg,30.0(10.0,45.0) min,1.0(1.0,2.0),and in the intervention group they were:89.5(56.0, 119.0) mmHg,10.0(5.0,15.0) min,1.0(0.0,1.0),the differences between two groupshad statistical significance (Z=-2.412,-3.668,-2.998,P<0.05).This showed that the grip strength was significantly increased compared with the control group,while the morning stiffness of the intervention group was significantly lower than the control group, and SOFI was significantly reduced compared with the control group, and all the differences were statistically significant. The results also showed that in the control group, the grip force did not change significantly three months later, and the difference was not statistically significant ( P>0.05), but in the intervention group, the grip strength was significantly higher three months later, and the morning stiffness and SOFI were significantly reduced in the group, and the differences were statistically significant (Z=-4.865,-5.508,-4.711, P<0.05). Conclusions The effect of anti-resistance training on the function of hand joint in rheumatoid arthritis patients is better than that of conventional finger operation, especially in improving the grip strength.
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Objective To explore the effect of finger exercises and cognitive training on cognitive function, ability of daily living and quality of life of elderly patients with mild cognitive impairment. Methods About 90 elderly patients with mild cognitive impairment were randomly divided into experimental group and control group. In the experimental group finger exercises and cognitive training were implemented, and the control group was given routine care and health education. 3 months and 6 months after the intervention, the two groups were compared in respect of the cognitive function, ability of daily living and quality of life. Results The difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between the two groups 3 month and 6 month after the intervention (P<0.05). Pairwise comparison done at three time points (before intervention, 3 months and 6 months after intervention) in the experimental group showed that the difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between before intervention and 3 months after intervention, before intervention and 6 months after intervention. Conclusion The finger exercises and cognitive training in elderly patients with mild cognitive impairment can effectively strengthen the cognitive function and ability of daily living, and improve the quality of life.