Age-related changes in the respiratory system

This article summarises the main structural and physiological changes which take place in the lung from young adulthood to senescence. An understanding of these changes helps the clinician to correctly interpret some results of radiology and pulmonary function frequently seen in clinical practice. An appreciation of the altered physiology and the consequent reduction in pulmonary reserve should alert the physician to the need for a more critical evaluation of the various respiratory parameters measured during illness in an older patient. Rhythmic breathing occurs virtually continuously over a lifetime and the alveolar gas-exchanging surface is brought into contact with more than 270 million litres of air, which may contain harmful particulate matter and noxious gas elements. Thus to separate changes in the respiratory system caused by ageing itself from those caused by environmental or work-related factors is extremely difficult and sometimes impossible. Chronic obstructive pulmonary disease (COPD) is possibly the most important disease entity related to age and environment. Epidemiological studies show that the prevalence of COPD is increasing. In the 1990’s prognostic models of COPD were developed. These have shown that age, ventilatory function, gender and smoking were the major determinants for the development of COPD. Other important factors were outdoor air pollution and occupation.peer-reviewe

Individualized care for older adults with diabetes and its relationship with communication, psychosocial self‐efficacy, resources and support for self‐management and socio‐demographics

Abstract Aim To examine the relationship between patient–provider communication, psychosocial patient self‐efficacy, resources and support for self‐management and socio‐demographics within individualized care of older adults with diabetes. Design A quantitative study with a cross‐sectional survey design. Methods Data were collected from September 2019 to January 2021 using: Individualized Care Scale, The Communication Assessment Tool, The Diabetes Empowerment Scale and The Resources and Support for Self‐Management Scale. Patients with either Type 1 or Type 2 diabetes mellitus that were 65 years old and over (N = 145) participated in the study. Results The most positive aspects of patient–provider communication were respect and creating a comfortable environment for the patient. A significant relationship was observed between patients' perceptions and support of individualized care and diabetes‐related measures. Effective communication was the main factor associated with support for individualizing care, and together with education level, empowerment and access to resources, explained 23% of the variance

Associations of the serotonin transporter gene polymorphism, 5-HTTLPR, and adverse life events with late life depression in the elderly Lithuanian population

Abstract Late-life depression (LLD) is a multifactorial disorder, with susceptibility and vulnerability potentially influenced by gene-environment interaction. The aim of this study was to investigate whether the 5-HTTLPR polymorphism is associated with LLD. The sample of 353 participants aged 65 years and over was randomly selected from the list of Kaunas city inhabitants by Residents’ Register Service of Lithuania. Depressive symptoms were ascertained using the EURO-D scale. The List of Threatening Events Questionnaire was used to identify stressful life events that happened over the last 6 months and during lifetime. A 5-HTTLPR and lifetime stressful events interaction was indicated by higher odds of depression in those with s/s genotype who experienced high stress compared to l/l carriers with low or medium stress, while 5-HTTLPR and current stressful events interaction analysis revealed that carriers of either one or two copies of the s allele had increased odds of depressive symptoms associated with stress compared to participants with the l/l genotype not exposed to stressful situations. Although no significant direct association was found between the 5-HTTLPR short allele and depression, our findings demonstrated that lifetime or current stressful life events and their modification by 5-HTTLPR genotype are risk factors for late-life depression

Photoplethysmography-Based Continuous Systolic Blood Pressure Estimation Method for Low Processing Power Wearable Devices

Regardless of age, it is always important to detect deviations in long-term blood pressure from normal levels. Continuous monitoring of blood pressure throughout the day is even more important for elderly people with cardiovascular diseases or a high risk of stroke. The traditional cuff-based method for blood pressure measurements is not suitable for continuous real-time applications and is very uncomfortable. To address this problem, continuous blood pressure measurement methods based on photoplethysmogram (PPG) have been developed. However, these methods use specialized high-performance hardware and sensors, which are not available for common users. This paper proposes the continuous systolic blood pressure (SBP) estimation method based on PPG pulse wave steepness for low processing power wearable devices and evaluates its suitability using the commercially available CMS50FW Pulse Oximeter. The SBP estimation is done based on the PPG pulse wave steepness (rising edge angle) because it is highly correlated with systolic blood pressure. The SBP estimation based on this single feature allows us to significantly reduce the amount of data processed and avoid errors, due to PPG pulse wave amplitude changes resulting from physiological or external factors. The experimental evaluation shows that the proposed SBP estimation method allows the use of off-the-shelf wearable PPG measurement devices with a low sampling rate (up to 60 Hz) and low resolution (up to 8-bit) for precise SBP measurements (mean difference MD = −0.043 and standard deviation SD = 6.79). In contrast, the known methods for continuous SBP estimation are based on equipment with a much higher sampling rate and better resolution characteristics

Explainable Artificial Intelligence-Based Decision Support System for Assessing the Nutrition-Related Geriatric Syndromes

The use of artificial intelligence in geriatrics is very promising and relevant, as the diagnosis of a geriatric patient is a complex, experience-based, and time-consuming process that involves a variety of questionnaires and subjective and inaccurate patient responses. This paper proposes the explainable artificial intelligence-based (XAI) clinical decision support system (CDSS) to assess nutrition-related factors (symptoms) and to determine the likelihood of geriatric patient health risks associated with four syndromes: malnutrition, oropharyngeal dysphagia, dehydration, and eating disorders in dementia. The proposed system’s prototype was tested under real conditions at the geriatric department of Lithuanian University of Health Sciences Kaunas Hospital. The subjects of this study were 83 geriatric patients with various health conditions. The assessments of the nutritional status and syndromes of the patients provided by the CDSS were compared with the diagnoses of the physicians obtained using standard assessment methods. The results show that proposed CDSS can efficiently diagnose nutrition-related geriatric syndromes with high accuracy: 87.95% for malnutrition, 87.95% for oropharyngeal dysphagia, 90.36% for eating disorders in dementia, and 86.75% for dehydration. The research confirms that the proposed XAI-based CDSS is an effective tool, able to assess nutrition-related health risk factors and their dependencies and, in some cases, makes even a more accurate decision than a less experienced physician

Effect of use of proton pump inhibitors on serum magnesium levels in older people:an observational study

No abstract availabl