1.Research progress in the prevention and treatment of elderly frailty through resistance exercise
Chao GAO ; Qiyu PAN ; Ziyi ZHOU ; Chunbo DUAN
Chinese Journal of Geriatrics 2024;43(6):662-667
Frailty is a clinical condition associated with aging, encompassing deficiencies in physical performance, nutritional status, mental health, and cognition.Physical exercise has proven to be an effective strategy for maintaining functional abilities and alleviating frailty symptoms in older adults.Exercise helps in preserving or enhancing bone density, muscle mass, strength, and overall function.In recent years, there has been increasing attention on the impact of resistance exercise on the prognosis of frailty in the elderly population.This article explores the mechanisms of resistance exercise in preventing and treating frailty, examines the effects of different types of resistance exercise on age-related weakness, and reviews related research on the use of resistance exercise for preventing and treating frailty.The findings of this study provide valuable insights for developing precise exercise prescriptions that incorporate multiple modes of exercise for frail older patients.
2.Relationship between frailty status and risk of death in the elderly based on frailty index analysis
Jing SHI ; Bing SHI ; Yongkang TAO ; Li MENG ; Ziyi ZHOU ; Shuqiang CHEN ; Chunbo DUAN ; Pulin YU
Chinese Journal of Epidemiology 2020;41(11):1824-1830
Objective:To analyze the relationship between frailty status and the risk of death in the elderly based on the frailty index (FI).Methods:Data from a prospective cohort study conducted between 2005 and 2015 in elderly people of an urban community in Beijing were analyzed. The variables related to health and frailty status based on the 2005 baseline survey and death as outcome variables collected in 2015 were used. A FI model was used to evaluate the correlation between FI and mortality in the elderly people in different age groups was analyzed. Cox regression was applied to evaluate the influence of FI on the risk of death, and Kaplan-Meier curves was used to show the survival rate of different frailty levels in the elderly adults.Results:Of the 1 301 elderly people included in the analysis, 403 died during 2005-2015, with the 10-year mortality rate of 31.0 %(403/1 301). The mortality rate of the elderly increased with the increase of FI, but, with the increase of FI value, the rate of mortality increased slowly. The limit value of FI causing death was around 0.70, indicating any new health problem might cause death at this value. Cox regression analysis showed that higher FI was associated with higher risk for death ( HR=1.143, 95 %CI: 1.034-1.248, P=0.000), and FI was more significantly associated with death than age ( HR=1.143 vs. HR=1.048, t=5.827, P=0.000). With the increase of age, the effect of frailty on the risk of death decreased ( HR=1.179 to HR=1.120). Kaplan-Meier curves showed that the survival rate of the elderly in all age groups decreased with the increase of frailty (Log-rank=317.812, 354.203, 247.258, all P=0.000). The survival time between different frailty levels in the elderly were significantly different, except for the elderly adults aged ≥80 years with severe frailty level (0.4≤FI<0.5, FI≥0.5, P=0.368). Conclusions:Compared with other evaluation tools of frailty, FI model can better reflect the frailty status of the elderly in communities in Beijing and has a high sensitivity in predicting adverse outcomes such as mortality. In the intervention of frailty in the elderly, focusing on relatively young elderly might be more effective in reducing the adverse outcomes caused by frailty.
3.Analysis of types and medication of common chronic diseases in the elderly visiting primary medical institutions in eight provinces and cities
Huiqing YAO ; Ziyi ZHOU ; Baiyu ZHOU ; Chunbo DUAN
Chinese Journal of Geriatrics 2019;38(7):800-805
Objective To investigate the types of common chronic diseases and common drugs in the elderly visiting primary medical institutions in China.Methods Cluster sampling was adopted in eight provinces/cities/autonomous region of Zhejiang,Jilin,Henan,Shanghai,Chongqing,Gansu,Guangxi and Jiangsu.Sampling sites were selected and information was collected through the online reporting system of common diseases and drug costs of the elderly in primary hospitals at all levels in China.On these grounds,the basic situation of primary medical institutions,the common chronic diseases and common drugs for people aged 65 years and above were investigated.Results Primary hypertension(65.7% or 46/70)and arthropathy(10.0% or 7/70)were the most common chronic diseases in the elderly visiting primary medical institutions.The consultation rate of primary hypertension was highest both in rural areas(58.3%,i.e.the ratio of 21 over 36 primary medical institutions)and in urban areas(73.5%,i.e.the ratio of 25 over 34 primary medical institutions).The primary medical institutions with consultation rates of hypercholesterolemia/hyperlipidemia (x2 =5.137,P=0.023),diabetes(x2 =3.868,P =0.049)and dyspepsia(Fisher's exact test,P =0.026)as the top 3 chronic diseases were more often seen in urban areas than in rural areas,while the primary medical institutions with consultation rates of cerebrovascular diseases as the top 3 chronic diseases were more often seen in the rural areas than in urban areas(x2=9.974,P =0.002).More primary medical institutions with consultation rates of benign prostatic hyperplasia and primary osteoporosis as the top 10 chronic diseases were found in urban areas than in rural areas(x2 =4.054 and 3.861,P =0.044 and 0.049,respectively),while more primary medical institutions with consultation rates of heart failure as the top 10 chronic diseases were found in rural areas than in urban areas(x2 =3.865,P =0.049).Aspirin,nifedipine and simvastatin one by one were most commonly used in people aged 65 years and over in primary medical institutions.Conclusions Primary hypertension is the most common chronic disease among the elderly visiting primary medical institutions in both rural and urban.Common chronic diseases in primary medical institutions are different between the urban and rural areas.Regional differences and urban-rural differences should be taken into account in drug preparation.There are some irregularities in the use of drugs and insufficient stocks of essential drugs in basic-level medical institutions.
4.Association between frailty and serum biomarkers in older adults
Hong SHI ; Li MENG ; Jing SHI ; Daguang WANG ; Cong SHAO ; Jing PANG ; Guoqing FAN ; Yuefan LI ; Shuai ZHANG ; Yuetao ZHAO ; Xue LI ; Jing LI ; Xin ZHAO ; Tiemei ZHANG ; Chunbo DUAN ; Pulin YU ; Huan XI
Chinese Journal of Geriatrics 2018;37(12):1383-1386
Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P<0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P>0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.
5.Research progress on the relationship between frailty and motor system diseases
Chao GAO ; Xiao TAN ; Chunbo DUAN ; Pulin YU
Chinese Journal of Geriatrics 2017;36(7):818-821
With the aging of the global population,frailty is now considered a unique old age syndrome,has become an important worldwide public health problems.The elderly people is at increased risk of falls,hip fractures,disability,death and other risks.Motor system disease as an independent risk factor participates in frailty progress and interacts with each other.This article reviews recent studies on frailty and motor system diseases.
6.Frailty and cardiovascular diseases
Xiao TAN ; Chao GAO ; Chunbo DUAN ; Haimei QI
Chinese Journal of Geriatrics 2017;36(6):704-709
Frailty is a geriatric syndrome that has been implicated as a causative and prognostic factor for cardiovascular disease (CVD).Frailty and CVD are often concurrent and mutually promotive.The prevalence of frailty ranges from 10% to 60% in patients with CVD,depending on different tools and cutoffs chosen to define frailty.Short-and long-term prognosis of CVD are both affected by frailty.The presence of frailty is correlated with an increase in complications,outpatient and emergency department visits,hospital admissions and stays,and mortality in patients with CVD.Early prevention and clinical intervention can delay or even reverse the development of frailty,thus improving the prognosis for CVD.
7.Correlation of frailty severity with muscle mass and physical function in Chinese older adults:preliminary findings
Li MENG ; Jing SHI ; Chenshuang ZOU ; Xiao TAN ; Baiyu ZHOU ; Chunbo DUAN ; Hong SHI ; Huan XI
Chinese Journal of Geriatrics 2017;36(12):1313-1317
Objective To explore the relationship between the severity of frailty and muscle mass/function in older people,and to determine whether and/or how the results would be influenced by the assessment method for frailty.Methods A total of 106 older adults aged 63-95 years were recruited from individuals undergoing regular health examinations at the Outpatient Department of Beijing Hospital.The characteristics of participants were collected through a questionnaire and subsequently evaluated.Frailty was assessed by both the Fried phenotype and an index of accumulated deficits (FI).Sarcopenia was identified based on the criteria of the Asian Working Group for Sarcopenia (AWGS).Average skeletal muscle mass,appendicular skeletal muscle mass and the appendicular skeletal muscle index (ASMI) were measured by bioelectrical impedance analysis (BIA).Furthermore,grip strength,the 4 m walking test,the timed up and go test (TUGT),the five times sit to stand test (FTSST),and the balance test were performed to investigate the physical performance.Results There were 15 (14.2%) frail and 65 (61.3%) pre-frail cases in this group.Poor grip strength 59 (55.7%) and slow gait speed 33 (31.1%) were more prevalent in frail older people.Meanwhile,when the phenotypic definition of frailty was used,muscle mass and ASMI decreased as the severity of frailty increased (F=6.579,3.969,4.507,respectively;all P<0.05).Frail older people had significantly slower gait speed and poorer grip strength than those who were not frail (F=23.897,4.583,respectively;both P<0.05).Moreover,frail older people were more likely to be sarcopenia (53.5%) than those who were pre frail (30.8%) or not frail (3.8%).Participants with frailty performed worse on FTSST,TUGT and the balance test (all P<0.05) and had markedly lower levels of FI (0.15±0.04,0.18±0.06,and 0.28±0.09,respectively;F=21.764,P<0.05) than those in the pre-frail and non-frail groups.Appendicular skeletal muscle mass,skeletal muscle mass,grip strength and walking speed were negatively correlated with FI (r =-0.256,-0.321,-0.343,-0.374,respectively;all P<0.05) while ASMI showed no statistical correlation with FI (P>0.05).Conclusions Poor grip strength and slow gait speed are very common in frail older people.There is a close correlation between muscle mass/function and frailty.The degree of association of frailty severity with physical performance remains largely unchanged regardless of what assessment method is used.
8.Analysis on literature distribution and research status of osteoporosis in the elderly published in Chinese Medical Association journals from 2008 to 2013
Qiukuan SHI ; Jing SHI ; Li MENG ; Chunbo DUAN ; Pulin YU
Chinese Journal of Geriatrics 2015;34(4):448-451
Objective To analyze the literature distribution and research status of osteoporosis in the elderly published in Chinese Medical Association journals.Methods The literatures of elderly osteoporosis published in Chinese Medical Association journals from 2008 to 2013 were collected.And the publication year,distribution,content,institution and region of the literatures were analyzed.Results From 2008 to 2013,there were 76 articles about osteoporosis in the elderly published in 22 kinds of journals of the Chinese Medical Association.Among these journals,the Chinese Journal of Geriatrics-published elderly osteoporosis articles occupied the most number [28 (36.8%)].There were 21 articles published mostly in 2013 (27.6%),secondly in 2009 (17 articles,22.4%) and 2012 (12 articles,15.8%).The province or city that published more than 10 articles was Beijing (18 articles,23.7%),Zhejiang (13 articles,17.1%),Shanghai (10 articles,13.2%) and Guangdong (10 articles,13.2%).The institution that published most articles was Beijing Jishuitan Hospital (4articles,5.3%).The main contents of these literatures included the influencing factors,diagnosis,treatment strategy,bone metabolism and surgery treatment for elderly osteoporosis.Conclusions Chinese Medical Association journals are the important source to acquire osteoporosis literature for the medical workers.The distribution of journal is relatively concentrated,but the distribution of authors,institution is dispersed.Chinese Journal of Geriatrics publishes the most number of articles.The research of osteoporosis has attracted more attention.
9.Analysis on literature distribution and research status of benign prostatic hyperplasia in the elderly published in Chinese Medical Association journals from 2009 to 2013
Shangxin LIU ; Xiao TAN ; Jing SHI ; Chunbo DUAN ; Chong XU ; Pulin YU ; Jianye WANG
Chinese Journal of Geriatrics 2015;34(2):215-218
Objective To analyze the literature distribution and research status of benign prostatic hyperplasia (BPH) in the elderly published in Chinese Medical Association journals.Methods The literatures of elderly BPH published in 88 kinds of Chinese Medical Association journals from 2009 to 2013 were collected.The publication year,distribution,content,author,institution and region of these literatures were analyzed.Results From 2009 to 2013,203 articles about elderly BPH were published in 10 kinds of journals.These literatures were published mostly in 2013 (50 articles,24.6%),secondly in 2010 (46 articles,22.7%) and 2009 (43 articles,21.2%),which were mostly published in Chinese Journal of Geriatrics (87 articles,42.9 %).Most researches were focused on the fields of clinical treatment of BPH in the elderly,etiology,cross-sectional investigation and perioperative nursing,while the progresses in pathophysiology and diagnosis were relatively small,and the most published form was treatise (166 articles,81.8%).Authors who published the most articles were Yang Yong from Department of Urology Surgery in PLA General Hospital and Zhang Xianghua from Department of Urology Surgery in Peking University First Hospital (both,4 articles,3.5 %),the institutions which published the most articles were Beijing Hospital and Beijing Chaoyang Hospital (both,9 articles,4.4 %),and the provinces or cities which published the most articles were Beijing (75 articles,36.9%),Shanghai and Zhejiang (both,17 articles,8.4%) and Hunan (16 articles,7.9%).Among the 203 articles,35 articles (17.2%) were supported by founds.Conclusions Chinese Medical Association journals are the important sonrce to acquire literatures on elderly BPH for medical workers.The distribution of journals is relatively concentrated,but the distribution of author,institution and region in these articles is dispersed.Studies on clinical treatment of elderly BPH,etiology,inventory survey and perioperative nursing are especially concerned within nearly 5 years.
10.Citation analysis of Chinese Journal of Geriatrics from 2003 to 2007
Chengran GUO ; Chunbo DUAN ; Chao GAO ; Pulin YU
Chinese Journal of Geriatrics 2014;33(1):93-95
Objective To analyze the citation status of Chinese Journal of Geriatrics,and to evaluate the authority and quality of this journal.Methods Literatures including original research articles,short reports of original studies,reviews and clinical case reports etc.from 2003 to 2007 were collected from China national knowledge internet (CNKI) and Wanfang Database.The citation frequency,author distributions,relevant journals and foundation status were statistically analyzed.Results Totally 1649 papers were published in Chinese Journal of Geriatrics from 2003 to 2007,among which 1280 papers were cited 9062 times by 946 kinds of journals,the average citation times was 7.08 times,and the top citation times was 131 times.270 articles were cited 10 or more times (21.09%).The top 3 relevant journals with high citations from Chinese Journal of Geriatrics were Chinese Journal of Gerontology,Chinese Journal of Geriatrics and Chinese Journal of Misdiagnostics (totally 591 times,6.52%).The self-citation rate was 1.95%.445 articles were supported by different kinds of funds (totally 112 kinds),and majority of articles were supported by National Natural Science Foundation of China.Articles supported by 106 kinds of funds were cited and the total citation times was 2312 times.Conclusions Literatures in Chinese Journal of Geriatrics have high quality and authority with an amount of readers and relatively stable relevant journals.Journal quality and academic level are highly improved,but further efforts are needed to promote the coordinated development of regions.

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