Abstract:Objective To investigate the status quo of quality of life and coping styles in elderly patients with multiple myeloma (MM) during maintenance treatment stage and analyze their correlation. Methods A total of 150 elderly MM patients admitted to our hospital from February 2018 to February 2023 were enrolled in this study. During induction/consolidation stage and maintenance treatment stage, their quality of life was investigated by European Organization for Research and Treatment of Cancer quality of life questionnaire-core 30 V3.0 (EORTC QLQ-C30 V3.0), and their medical coping styles were surveyed with medical coping modes questionnaire (MCMQ). SPSS statistics 19.0 was used for data analysis, and Pearson correlation analysis was conducted to assess the correlation between quality of life and medical coping styles in elderly MM patients during maintenance treatment stage. Multivariate linear regression analysis was applied to identify the related factors affecting quality of life during the stage. Results The scores of physical function, role function, emotional function, cognitive function, social function and overall quality of life, and the score of financial difficulty dimension during maintenance treatment stage were higher than those during induction/consolidation treatment stage, but the scores of functional dimensions and overall quality of life of patients during maintenance treatment stage were lower, while the score of financial difficulty dimension was higher than the norm (P<0.05). The patients also had significantly higher scores of avoidance dimension and submission dimension, but lower score of facing dimension during induction/consolidation treatment stage and maintenance treatment stage when compared with the norm (P<0.05). Pearson correlation analysis indicated that the facing dimension (r=0.315; P<0.001) was positively correlated, while the submission dimension (r=-0.256; P<0.001) was negatively correlated with the overall quality of life in the elderly MM patients during maintenance treatment stage. Multivariate linear regression analysis revealed that facing dimension (β=0.311, P=0.019) had a positive predictive effect, while submission (β=-0.293, P=0.023), international staging system (ISS) stage (β=-0.298, P=0.032), self-paying treatment ratio (β=-0.216, P=0.038) and hemoglobin level (β=-0.243, P=0.046) had a negative predictive effect on the overall quality of life score in elderly MM patients during maintenance treatment stage, which together explained 42.9% of the variance of the overall quality of life score. Conclusion The quality of life in elderly MM patients during maintenance treatment stage is higher than that during induction/consolidation treatment stage, but still lower than the norm. Elderly MM patients during maintenance treatment stage tend to choose negative coping styles. It is suggested to improve the medical coping styles during maintenance treatment stage to promote the quality of life in elderly MM patients.

Abstract:Objective To investigate the effect of left ventricular (LV) myocardial work on left atrial reservior function in hypertension patients with different grades of heart failure (HF). Methods A total of 78 hypertension patients admitted in Sixth Medical Center of Chinese PLA General Hospital from March to April 2022 were consecutively recruited in this study. According to European Society of Cardiology heart failure classification, 43 patients with normal heart function were assigned into control group, 8 patients with ejection fraction(EF) <50% into HF with reduced ejection fraction (HFrEF) group, and 27 with EF ≥50% into HF with preserved ejection fraction (HFpEF) group. Vivid E95 4D Cardiac Ultrasound Machine (GE) was used to acquire 2D and 3D echo images, and 4D auto LAQ was employed to calculate LA volume and LASr. Based on LV longitudinal strain and blood pressure, pressure-strain loop were calculated to obtain LV myocardial work indicators, including global work index (GWI), global constructive work (GCW), global waste work (GWW) and global work efficiency (GWE). SPSS statistics 23.0 was used for statistical analysis. Data comparison between two groups was performed using student′s t test, ANOVA or Chi-square test depending on data type. Pearson correlation coefficient and covariance analysis were applied to investigate the correlation between LV myocardial work indicators and LASr. Results The GWI and GCW values were significantly higher in the control and HFpEF groups than the EFrHF group (P<0.01). The GWW value in the EFrHF and HFpEF groups was obviously higher than that in the control groups (P<0.05). Statistical differences were observed in the GWE value between any two groups, and the lowest value was seen in the HFrEF group, and that of the control group was higher than the EFpHF group (P<0.01). There were notably difference in LASr among the three groups, with the control group having the highest and the EFrHF group the smallest (P<0.01). A liner relationship was observed between GWI and LASr in different groups, which was independent of grouping. After controlling the effect of GWI, ANOVA indicated that significant difference was seen in LASr among the patients with different cardiac function (F=9.46; P<0.01). The worse the cardiac function was, the lower the LASr. Conclusion For the patients with EF <50%, both GWI and GCW values are decreased, while GWW value is increased. The HFpEF patients still have normal LV myocardial work, though with increasing GWW and declining GCW. No matter which classification of HF, LASr is reduced with the decline of GWI. 3D LA reservoir strain can be used as one of indicators for evaluating left ventricular function in clinical practice.

Abstract:Objective To study the changes of quality of life in patients with senile degenerative heart valvular disease (SDHVD) after aortic valve replacement and analyze the related influencing factors. Methods Totally 140 patients with SDHVD admitted to the First Affiliated Hospital of Nanjing Medical University from April 2020 to April 2022 were enrolled as the study subjects, and they had simple aortic valve calcification and underwent aortic valve replacement (AVR) due to typical symptoms. Short-form-36 health survey (SF-36) was used to evaluate the quality of life before surgery and at re-visit at one year after surgery, and the value of AVR on improving the quality of life of patients was analyzed. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test, analysis of variance orχ² test depending on data type. Multivariate linear regression model was applied to analyze the related factors affecting the postoperative quality of life of patients. Results After excluding deaths during perioperative period and loss of follow-up and deaths during follow-up period, 118 of 140 elderly patients with SDHVD who underwent AVR had complete follow-up data. At one year after surgery, the scores of physical function, role physical , bodily pain, general health and vitality and total score of SF-36 scale were increased compared with those before surgery, but were still lower than the norms (P<0.05). Multivariate linear regression analysis indicated that body mass index (BMI) and mean transvalvular pressure difference had negative predictive effects on quality of life at one year after surgery in elderly patients with SDHVD (β=-0.374, -0.153；both P<0.001); regular exercise, preoperative left ventricular ejection fraction (LVEF) and effective orifice area index(EOAI) index had positive predictive effects on quality of life of patients at one year after surgery (β=0.177,0.276,0.311；all P<0.001), witch could jointly explain 41.70% of the variance of quality of life of patients. Conclusion The quality of life at one year after AVR in elderly SDHVD patients is generally higher than that before AVR, but it is still lower than the norm level. BMI, regular exercise, preoperative LVEF, mean transvalvular pressure difference and EOAI are related factors affecting the quality of life at one year after AVR in elderly SDHVD patients.

Abstract:Objective To explore the value of cardiac rehabilitation training in improving the daily living ability, cardiac function and quality of life of the elderly patients with chronic coronary heart disease. Methods The study objects included 160 elderly patients with stable angina pectoris with chronic coronary heart disease, who underwent elective percutaneous coronary intervention (PCI) in Beijing Tiantan Hospital affiliated to Capital Medical University from May 2019 to October 2021. The patients were divided into an observation group (n=80) and control group (n=80) by random number table method. The control group received routine intervention after PCI, and the observation group received cardiac rehabilitation training intervention on the basis of routine intervention. The cardiac function [left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV)], quality of life and daily living ability were compared between the two groups before and after intervention. The incidence of adverse cardiovascular events within six months after PCI was counted. SPSS 22.0 was used to process the data, and one-way ANOVA, t test orχ² test was used for inter-group comparison according to the data type. Results After intervention, LVEF in the observation group was significantly higher, and LVEDV was significantly lower than that in the control group (t=5.852,12.850; P<0.05). The scores of each dimension of the quality of life and daily living ability at four and six months after intervention in the observation group were significantly higher than those in the control group, with statistically significant differences (t=2.525,3.682,3.099,2.857,2.497,2.167,2.243; P<0.05). The overall incidence of cardiovascular adverse events in the observation group was significantly lower than that in the control group , and the difference was statistically significant (χ²=4.717; P<0.05). Conclusion Cardiac rehabilitation training in the elderly patients with stable angina pectoris due to chronic coronary heart disease can improve cardiac function, contributing to the improvement of their daily living ability and quality of life, and it is worthy of clinical promotion and application.

Abstract:Objective To study the disease characteristics and influencing factors of quality of life in elderly patients with peptic ulcer (PU). Methods A total of 120 elderly PU patients in Beijing Royal Integrative Medicine Hospital from January to June 2021 were selected. Upon enrollment, various examinations were completed and clinical data were recorded in detail. The sleep quality of the patients was assessed by Pittsburgh Sleep Quality Index (PSQI), the quality of life by MOS 36-item short-rorm health survey (SF-36), and the self-care ability by Exercise of Self-Care Agency Scale (ESCA). The clinical characteristics such as demographic characteristics, disease causes, onset seasons, clinical symptoms, special medication, and complications of the elderly PU patients were statistically analyzed. SPSS 23.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test, depending on data type. Multivariate linear regression model was used to analyze the factors affecting the quality of life of the elderly PU patients. Results The elderly PU patients were mainly male (male∶female=1.67∶1), including 68 (56.67%) of gastric ulcer (GU) and 52 (43.33%) of duodenal ulcer (DU). The use of antipyretic or analgesic drugs (50.83%) was the main cause of PU in the elderly. In the elderly PU patients, the proportions of typical PU symptoms such as regular abdominal pain (17.50%) and regular abdominal distension (21.67%) were low, and the proportions of atypical symptoms such as melena (41.67%), fatigue (35.00%) and acid reflux (40.00%) were high. In terms of special medication history, the patients using non-steroidal drugs accounted for 23.33% (28/120), and those using anticoagulant drugs accounted for 33.33% (40/120). Among the elderly PU patients, 22.50% had peptic ulcer bleeding, 8.33% had ulcer perforation, and 5.83% had pyloric obstruction. By comparison, the proportions of patients with ulcer diameter > 2 cm, with multiple ulcers, and with intestinal metaplasia and atypical hyperplasia in the GU group were higher than those in the DU group, while the proportion of patients with Helicobacter pylori infection in the GU group was lower than that in the DU group, and the differences were statistically significant (P<0.05 for all). In addition, the scores of physical function, role physical, general health, vitality, mental health, and the total score on the SF-36 scale in the elderly PU patients were lower than those of the domestic norms, and the differences were statistically significant (P<0.05 for all). Multivariate linear regression analysis showed that sleep disorders (β=-0.274; P<0.001), PU-related complications (β=-0.343; P<0.001), and anxiety (β=-0.184, P<0.001) could negatively predict the quality of life of the elderly PU patients, while high level of self-care ability (β=0.313; P<0.001) could positively predict the quality of life, which together explained 31.50% of the variation of the patients′ quality of life. All 120 patients underwent endoscopic follow-up examination after treatment. Excluding those who were lost to follow-up, 14 (18.42%) of the remaining 76 patients relapsed and were readmitted during follow-up. Conclusion The proportion of the male PU patients is higher than that of the female patients; GU is more common; the clinical symptoms of patients are not typical; PU-related complications are more common, mainly peptic ulcer bleeding; the main cause of the disease is the use of antipyretic or analgesic drugs. In addition, the comorbidities are complex, the quality of life is significantly reduced, and the readmission rate is higher.

Abstract:Objective To investigate the prevalence, related risk factors, and clinical characteristics of sarcopenia in elderly urban populations in Nanjing, and explore the correlation between sarcopenia and hypertension. Methods A total of 2 536 elderly people who participated in annual physical examinations in Maigaoqiao Community Medical Center in Nanjing from January to December 2020 were recruited in this study. Their basic characteristics, life style, history of underlying diseases, and laboratory examination were surveyed and collected. According to whether they meet the diagnostic criteria for sarcopenia, the participants were divided into a sarcopenia group (198 cases) and a control group (2 338 cases). SPSS statistics 24.0 was used for data analysis. Depending on data type, student′s t test, Z test or Chi-square test was employed for intergroup comparison. Logistic regression analysis was applied to identify the influencing factors for sarcopenia. Results The prevalence of sarcopenia was 7.8% (198/2 536) in the participants, and the prevalence was increased with aging and with increment of blood pressure with statistical significances (all P<0.05). Hypertension (OR=3.075,95%CI 2.077-4.551; P<0.001) and elevated creatinine (OR=1.010,95%CI 1.003-1.016; P=0.005) were independent risk factors for sarcopenia, while low body mass index (BMI) (OR=0.676,95% CI 0.632-0.723; P<0.001), dairy intake (OR=0.532,95%CI 0.379-0.748; P<0.001) and exercise (OR=0.216,95%CI 0.150-0.312; P<0.001) were independent protective factors for sarcopenia. The prevalence of sarcopenia in hypertensive participants was 9.1% (151/1656). Advanced age (OR=1.156,95%CI 1.119-1.194; P<0.001), elevated urea nitrogen (OR=1.177,95%CI 1.045-1.324; P=0.007), and increased hemoglobin (OR=1.026,95% CI 1.010-1.043; P=0.001) were independent risk factors for sarcopenia in the hypertensive population, while low BMI (OR=0.613,95%CI 0.559-0.673; P<0.001), dairy intake (OR=0.499,95%CI 0.320-0.778; P=0.002), and exercise (OR=0.148,95%CI 0.093-0.235; P<0.001) were independent protective factors for sarcopenia in the hypertensive population. Conclusion The prevalence of sarcopenia is increased with the increment of blood pressure. Hypertension is an independent risk factor for sarcopenia, so more attention should be paid to sarcopenia in elderly patients with hypertension.

Abstract:Objective To explore the postoperative quality of life and its influencing factors in elderly female patients with osteoporotic vertebral compression fractures (OVCF). Methods A cross-sectional study was conducted on 173 elderly female OVCF patients undergoing surgical treatment in our medical center from December 2020 to June 2023. The enrolled patients were given questionnaires and instructed to fill them out, which included three parts, that is, general data, fracture and treatment, and quality of life. SPSS statistics 23.0 was used for data processing, and student′s t test or Chi-square test was performed depending on data type. Multivariate linear regression analysis was employed to identify the related factors of postoperative quality of life in elderly female patients with OVCF. Results The scores of physical function, pain, role physical, general health status, energy, psychological state and social function of 36-item short-form health survey (SF-36) were significantly lower in elderly female OVCF patients after surgery than the domestic norms (P<0.05). Marital status (β=-0.168, P=0.036), average monthly family income (β=0.273, P=0.019), bone mineral density (β=0.152, P<0.001) and anti-osteoporosis therapy (β=0.367, P=0.004) were the influencing factors of postopera-tive quality of life in elderly female patients with OVCF (P<0.05). Conclusion The quality of life is quite poor in elderly female patients with OVCF after surgery, and marital status, average monthly family income, bone mineral density and anti-osteoporosis therapy are related factors affecting their quality of life.

Abstract:Objective To investigate the short-term quality of life in the elderly critically ill patients after liver cancer surgery and to analyze its influencing factors. Methods A retrospective analysis was made of the clinical data of 152 elderly critically ill patients admitted to intensive care unit after liver cancer surgery in the Affiliated Cancer Hospital of Xinjiang Medical University from February 2020 to March 2022. Before surgery and at three months after surgery, geriatric nutritional risk index (GNRI) was used to assess the nutritional risk of patients. At three months after surgery, quality of life with liver cancer (QOL-LCV2.0) was used to evaluate the short-term quality of life. Patients were classified into the good life-quality group (n=78) and poor life-quality group (n=74) according to the quality of life measured at three months after surgery. SPSS 24.0 was used for data analysis. According to the data type, Chi-square test or t test was used to compare the enumeration data between groups. Logistic regression analysis was used to evaluate the influencing factors of poor short-term quality of life in the elderly critically ill patients after liver cancer surgery. Results At three months after surgery, the total score on QOL-LCV2.0 of the elderly critically ill patients after liver cancer surgery was (124.89±9.22) points. Logistic regression analysis showed that age ≥ 70 years (OR=1.929,95%CI 1.011-4.290; P<0.05), preoperative GNRI≤ 98 (OR=3.593,95%CI 2.252-5.734; P<0.05), and postoperative complications (OR=2.550,95%CI 1.411-4.606; P<0.05) were risk factors for poor short-term quality of life in the elderly critically ill patients after liver cancer surgery. Conclusion The short-term quality of life in the elderly critically ill patients after liver cancer surgery is worthy of attention. Age, nutritional risk and postoperative complications are important factors affecting their short-term quality of life.

Abstract:Objective To investigate the quality of life in the elderly patients with diabetic peripheral neuropathy (DPN) and the influencing factors. Methods A total of 156 elderly T2DM patients with DPN admitted to Tunchang People′ s Hospital from January 2019 to December 2022 were included in the observation group, and 263 elderly T2DM patients without DPN in the control group. The quality of life was investigated by diabetes specific quality of life scale (DSQL), the fear of disease progression by the fear of progression questionnaire-short form (FoP-Q-SF), the anxiety status of patients by the Hamilton anxiety scale (HAMA), and the severity of neuropathy in patients by the Michigan neuropathy screening instrument (MNSI). SPSS 23.0 was used for data processing, and multivariate linear regression analysis was used to analyze the factors affecting the quality of life of patients in the observation group. Results The DSQL scores of each dimension and the total score in the observation group were higher than those in the control group, the proportions of patients with FoP-Q-SF score ≥ 34, psychological dysfunction and anxiety were higher than those in control group; the total MNSI score was also higher in the control group, and the differences were statistically significant (P<0.05). Multivariate linear regression analysis suggested that having regular caregivers (β=-0.633; P<0.001), age (β=0.287; P<0.001), self-rated economic burden of disease (β=0.226; P<0.001), fear of disease progression (β=0.648; P<0.001), anxiety (β=0.513; P<0.001), MNSI questionnaire score (β=0.578; P<0.001) and painful DPN (β=0.715; P<0.001) were factors affecting DSQL score in the observation group, which jointly explained 62.50% of the variation in quality of life. Conclusion The quality of life in the elderly T2DM patients with DPN is generally lower than that of the patients without complications. In addition to age, self-rated economic burden of disease, severity of neuropathy and painful DPN, psychological disorders such as fear of disease progression and anxiety can also affect the patients′ quality of life. Additionally, patients with regular caregivers have a higher quality of life.

Abstract:Objective To investigate the correlation between intestinal metaplasia (IM) characteristics with Helicobacter pylori (Hp) infection and gastrointestinal hormones in the elderly with chronic atrophic gastritis (CAG). Methods From January 2019 to June 2023,130 elderly patients with CAG and IM in Dangtu People′s Hospital of Anhui Province were selected as the IM group, and 130 CAG elderly patients without IM as the non-IM group during the same period. The correlation between IM characteristics, Hp infection and gastrointestinal hormones [pepsinogenⅠ (PGⅠ), pepsinogen Ⅱ(PGⅡ), and gastrin-17 (G-17)] was analyzed. SPSS 22.0 was used for data analysis. According to the data type, comparison between groups was performed using t test, analysis of variance or Chi-square test respectively. Pearson correlation analysis was used to evaluate the correlation between IM characteristics, Hp infection and gastrointestinal hormones. Results The proportions of Hp infection and serum G-17 level in the IM group were higher than those in the non-IM group (P<0.05), the PGⅡ was lower than that in non-IM group, and the difference was statistically significant (P<0.05). The proportion of incomplete IM morphology, severe inflammation and Sydney score of the patients with Hp infection (Hp group) in the IM group were higher than those in the non-Hp infection group (non-Hp group), and the difference was statistically significant (P<0.05). PGⅠ/PGⅡ in IM incomplete morphology in the IM group was lower than that of the complete morphology, and the PGⅠ/PGⅡ in patients with mild, moderate and severe inflammation decreased in order. The G-17 level in IM incomplete morphology was higher than that of complete morphology, and the G-17 level increased in order in patients with mild, moderate and severe inflammation, with statistically significant differences (P<0.05). Pearson correlation analysis showed that the Sydney score of the IM patients was negatively correlated with PGⅠ/PGⅡ (r=-0.592; P<0.001) and was positively correlated with G-17 (r=0.624; P<0.001). Conclusion Hp infection, PGⅠ/PGⅡ and G-17 have correlation with IM morphology, inflammation degree and Sydney score.

Abstract:Objective To study the clinical characteristics in elderly inpatients with delirium and investigate the clinical application value of non-drug intervention. Methods A prospective trial was conducted on 200 elderly inpatients admitted to our department from June 2022 to June 2023. According to whether delirium occurred during hospitalization, they were divided into delirium group and non-delirium group. Clinical characteristics of delirium were statistically analyzed, and the value of non-drug intervention in improving their prognosis was studied. SPSS statistics 22.0 was used for statistical analysis. Intergroup comparison was performed using student′s t test or Chi-square test depending on data type. Multivariate logistic regression analysis was applied to identify the related factors affecting the occurrence of delirium in elderly inpatients. Results The incidence rate of delirium was 47.00% (94/200) in the 200 elderly inpatients, of which 30.85% (29/94) were accompanied by dementia. The delirium patients were mainly acute onset (85.11%, 80/94), and generally had clinical manifestations such as consciousness disorder, attention disorder, disorientation and cognitive dysfunction. Multivariate logistic regression analysis suggested that visual/auditory impairment (OR=5.562,95%CI 2.390-12.946), cognitive dysfunction (OR=3.823,95%CI 1.975-7.400), limited activity (OR=1.962,95%CI 1.287-2.990), malnutrition (OR=3.710,95%CI 1.638-8.401), anemia (OR=1.902,95%CI 1.638-8.401) and dementia (OR=2.210,95%CI 1.547-3.157) were risk factors for delirium in elderly inpatients (P<0.05). The risk prediction model of delirium in elderly inpatients was Logit (P)=-1.442+1.716×visual/auditory impairment+1.341×cognitive impairment+0.674×limited activity+1.311×malnutrition+0.643×anemia+0.793×dementia. Hosmer-Lemeshow test displayed that the model had goodness of fit, with Chi-square=21.157 and P<0.001, indicating that the model was significant in predicting delirium in elderly inpatients. Among the 94 elderly inpatients with delirium, 66 cases received only non-drug intervention, and the delirium duration was 1-14 d, with an average of (6.61±1.79) d. After one week of non-drug intervention, the score of Delirium Rating Scale-Revised-98 was significantly decreased than before intervention (P<0.05). Among the 66 patients with non-drug intervention, 40 (60.61%) were cured and 26 (39.39%) were improved at discharge. Conclusion The incidence of delirium is quite high in elderly inpatients. Most of them are acute onset, in hyperactive type, and with diverse and typical clinical manifestations. But dementia is more common in this group. Clinically, attention should be paid to the differentiation of dementia and delirium. The risk factors of delirium in elderly inpatients are mainly predisposing factors, and non-drug intervention shows generally better efficacy.

Abstract:Cognitive decline affects the physical function of the elderly in communities and is closely related to the occurrence, development, and adverse outcomes. By reviewing the concept, screening tools, current status, and significance of cognitive decline in the elderly in communities at home and abroad, in this article, we compared and analyzed the differences resulting from screening methods and tools for cognitive decline in order to improve the screening rate of cognitive decline in the elderly in communities in China and provide a more scientific basis for the development of accurate intervention measures.

Abstract:In response to the challenges of population ageing, the World Health Organization has introduced the concept of intrinsic capacity, marking a significant shift in the current healthcare paradigm. In geriatrics, frailty and intrinsic capacity are conceptually complementary and mutually reinforcing, but the relationship between the two concepts is still entirely unclear, which leading to complexity in their identification and application. Current evidence has shown that the two are closely associated and have important prognostic value for health indicators in older adults. Further research is needed to elucidate the complex link between the two concepts. In this article, we explore the application of the concepts of frailty and intrinsic capacity in the context of healthy aging, and compare their definitions, assessment methods, detection rates, and interventions.

Abstract:As the global population aging, the health concerns of the elderly are attracting more and more attention. Due to the declines of physiological functions, the elderly are highly prone to comorbidity and frailty, which leads to a decrease in their quality of life, reduced self-care capability, increased hospitalization rates and higher mortality risk. The occurrence of frailty in elderly patients with comorbidities is related to various factors, including demographic characteristics such as advanced age and education level, as well as social factors like malnutrition, lack of exercise and psychological stress. Interventions for comorbidity and frailty mainly include nutritional supplementation, physical exercise and psychosocial support for the elderly. These measures are of great clinical importance in slowing the progression of frailty and improving comorbidity management. In this article, we review the influencing factors and interventional measures for comorbidity and frailty in the elderly, aiming to provide a reference for clinical healthcare profe-ssionals to take effective measures for the prevention and management of frailty.