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ABSTRACT Background Methods Results Conclusion On 6 February, 2023, Turkey experienced a disaster resulting from two major earthquakes. The elderly population stands out as one of the most vulnerable and least adaptable. This study aims to identify the quality of life (QOL) and post‐traumatic stress disorder (PTSD) symptoms among elderly earthquake survivors in Turkey.This research was conducted between 1 October, 2023 and 15 December, 2023 as a cross‐sectional design. During the data collection process, survey questions prepared by the researchers (29 questions) and the Elderly Quality of Life Scale (OPQOL‐Bref) and the Impact of Events Scale (IES‐R) were used.Three hundred and eighty‐four elderly people participated in the study. PTSD was more common in those diagnosed with chronic diseases after the earthquake, in those who had a drug‐free period after the earthquake, in those who smoked and quit smoking, and in those who started psychiatric medication after the earthquake. Post‐traumatic stress was seen more frequently in those with low QOL scores and in those who had a longer period of not using medication after the earthquake. It was observed that QOL was better in married people, high school graduates, those with average income levels, those who did not have chronic diseases before and after the earthquake, those who did not have a drug‐free period after the earthquake, those who were physically active, and those who did not use psychiatric medication after the earthquake.Chronic disease diagnosis post‐earthquake, drug‐free periods, smoking habits, and psychiatric medication usage were identified as influential factors in PTSD occurrence. Additionally, the study shed light on the profound effect of earthquake‐related experiences, such as house damage, injuries, deaths in first‐degree relatives, displacement, and changes in living conditions, on PTSD prevalence. [ABSTRACT FROM AUTHOR]

BRAF is a mediator that activates the mitogen‐activated protein kinase pathway. A mutation in BRAF can cause abnormal pathway activation, leading to cell proliferation. In a Phase II study, the combination therapy of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib was found to be effective in non‐small cell lung cancer (NSCLC) patients with the BRAF mutation. However, this study has limited efficacy and safety data for elderly patients. We present a case of a patient who started treatment at 87 years old and showed a good prognosis, remaining alive 73 months from the start of treatment with no significant adverse events. The patient also maintained a partial response (PR) according to RECIST 1.1 at the last follow‐up. This case suggests that the dabrafenib and trametinib combination therapy is safe and effective for elderly NSCLC patients with the BRAF mutation. [ABSTRACT FROM AUTHOR]

Aim: To investigate the factors affecting postoperative frailty and the relationship between frailty and postoperative recovery in patients undergoing cardiovascular surgery. Design: The study was descriptive, cross‐sectional, and predictive. Methods: Data were collected by researchers in a university research and application hospital cardiovascular surgery inpatient clinic between March 2022 and March 2023. Sociodemographic‐Clinical Characteristics Form, Comorbidity Index, Edmonton Frail Scale, Postoperative Recovery, and Nutritional Risk Screening were used to collect the data. Results: Of the 145 patients included in the study, 65.51% (n = 95) were male and the mean age was 62.02 ± 10.16 years. While frailty was not found to be significant by age group, it was found that women had more comorbidities and were more frail than men. It was found that 17.2% (n = 25) of patients had a history of falls before surgery, 26.2% (n = 38) had a fear of falling after surgery and 17.24% (n = 25) had rehospitalisations. While postoperative recovery index predicted fraility by 34% in patients undergoing cardiovascular surgery; general symptoms and psychological symptoms, which are the sub‐dimensions of the postoperative recovery index and comorbidity and, fear of falling after surgery predicted frailty by 61%. The order of importance of variables on fraility: general symptoms (β = 0.297), fear of falling (β = 0.222), psychological symptoms (β = 0.218), Charlson Comorbidity Index (β = 0.183). Patient or Public Contribution: This study clarifies the role of frailty as an important factor influencing the recovery process in patients undergoing cardiovascular surgery. The findings show that frailty has a determining effect on postoperative recovery in these patients. Among the factors affecting frailty status, comorbidities, fear of postoperative falls, and postoperative general and psychological symptoms were found to contribute. These findings emphasise that these factors should be taken into account when assessing and managing the postoperative recovery process. Understanding these factors that influence postoperative frailty is crucial for patient care. Recognising the multifaceted nature of frailty, personalised interventions are needed to improve patient care and postoperative outcomes. Personalised interventions are particularly important for older women with multiple comorbidities, as they are more likely to be frail. [ABSTRACT FROM AUTHOR]

Purpose: Exergames are an innovative method that can promote neuroplasticity and improve the cognitive abilities of the elderly. This study aimed to compare the effects of single-task and multi-task exergames on the cognitive ability of the elderly with mild cognitive impairment (MCI). Methods: Computerized literature search was performed using PubMed, Web of Science, EBSCO, Elsevier, ProQuest, China National Knowledge Infrastructure (CNKI), Wanfang and VIP database to identify relevant articles from the establishment of the database from inception to April 1, 2024. The inclusion criteria were: (i) participants aged 60 or older diagnosed with mild cognitive impairment, regardless of gender; (ii) use of randomized controlled trials (RCTs); (iii) interventions involving exergames with physical activity or as the primary variable; and (iv) outcome measures using standardized neuropsychological instruments to assess cognitive function, including statistical data on sample size, mean, and standard deviation. Finally, the included study comprised a total of 526 participants. Mean difference (MD) and 95% confidence interval (CI) were used to synthesize the effect size in the data. Results: 11 studies were included. Due to the differences in the intervention methods, subgroup analysis was performed on the included research. Compared with the control group assessed by the Montreal Cognitive Assessment Scale, the single-task intervention improved the cognitive ability of the elderly with MCI (MD 3.40, 95% CI 2.43-4.37), the Mini-Mental State Examination Scale (MD 2.38, 95% CI μ2.03 to 2.72), the Trail Making Test (MD μ3.89, 95% CI â6.45 to â1.33), and the Digit Span Forward test (MD 1.16, 95% CI 0.73-1.60). Conclusion: This meta-analysis supports that exergames could be an effective cognitive rehabilitation method for MCI patients. Our study recommends that patients implement a customized exergames program and adhere to it for a long time. It is necessary to pay attention to the exercise guidelines and provide evidence from clinicians. [ABSTRACT FROM AUTHOR]

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract BRAF is a mediator that activates the mitogen‐activated protein kinase pathway. A mutation in BRAF can cause abnormal pathway activation, leading to cell proliferation. In a Phase II study, the combination therapy of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib was found to be effective in non‐small cell lung cancer (NSCLC) patients with the BRAF mutation. However, this study has limited efficacy and safety data for elderly patients. We present a case of a patient who started treatment at 87 years old and showed a good prognosis, remaining alive 73 months from the start of treatment with no significant adverse events. The patient also maintained a partial response (PR) according to RECIST 1.1 at the last follow‐up. This case suggests that the dabrafenib and trametinib combination therapy is safe and effective for elderly NSCLC patients with the BRAF mutation.

Objective To compare the effects of remimazolam vs propofol on the quality of recovery in elderly patients undergoing fundus daytime surgery after general anesthesia. Methods A total of 110 elderly patients undergoing day-time fundus surgery under laryngeal mask anesthesia were randomly divided into Remimazolam group and Propofol group. Patients in Remimazolam group were induced by remimazolam, sufentanil and rocuronium, and maintained by remimazolam and remifentanil. Patients in Propofol group were induced by propofol, sufentanil and rocuronium, and maintained by propofol and remifentanil. The level of sedation was monitored by bispectral index. After surgery, patients were antagonized by flumazenil in Remimazolam group but not in propfolgroup. The quality of patients' recovery was recorded before operation and three days after operation measured by quality of recovery-15 (QoR-15) scale. Intraoperative hemodynamic data, the time to consciousness loss during induction and awakening after operation, the time for laryngeal mask removal and the incidence of adverse events after admission to post anesthesia care unit were also recorded. Results The QoR-15 score in Remimazolam group 24 hours after operation was non-inferior to that in propofol group (133.3 ±11.1 vs. 135.0±10.3; mean difference (95% CI) 1.7 (-3.9, 7.2); approving for non-inferiority). There was no significant difference in QoR-15 scores between the two groups before operation or any other setting points. Compared with Propofol group, the time to consciousness loss during induction was prolonged, and the time for awakening after operation and laryngeal mask removal were shortened in Remimazolam group (all P < 0.05). Compared with Propofol group, the hemodynamics of patients in Remimazolam group was more stable (P < 0.05). There was no significant difference in the total dosage of remifentanil, fluid, or in the incidence of adverse reactions in PACU between the two groups (P > 0.05). Conclusion In elderly patients undergoing day-time fundus surgery, induction and maintenance of anesthesia with Remimazolam could achieve the similar quality of postoperative recovery with propofol. Compared with propofol, remimazolam provide more stable hemodynamics and shorter recovery time and extubated time, contributing to higher efficiency in recovery period. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore the predictive value of predialysis plasma osmolality for frequent intradialytic hypotension (IDH) in elders on maintenance hemodialysis (MHD).MethodsAccording to whether or not there was frequent IDH, 301 MHD elders were assigned into two groups of control (n=257) and frequent IDH (n=44). General profiles, laboratory parameters and cardiac B-ultrasound examinations were recorded. The risk factors for frequent IDH were identified by multivariate Logistic regression. Receiver operating characteristic (ROC) curve was plotted for exploring the predictive efficacy of predialysis plasma osmolality for frequent IDH.ResultsAs compared with control group, ultrafiltration rate, parathyroid hormone (PTH) and predialysis plasma osmolality spiked obviously while hemoglobin, serum albumin (Alb), left ventricular ejection fraction (LVEF) and Kt/V declined markedly in frequent IDH group (all P

As individuals diagnosed with Parkinson's disease enter older age, the myriad challenges and complications associated with this condition tend to escalate. Hence, there is a critical necessity to comprehensively discern the perceived needs of these individuals, along with their proposed remedies and essential support requisites. Additionally, understanding the perspectives of their families becomes imperative to formulate tailored interventions aimed at enhancing their overall development, progression, and quality of life. The study's main objective is to assess the perceived needs of individuals with PD and their family members, propose necessary solutions, and suggest future perspectives. The study encompassed a cohort of 268 participants, comprising 179 individuals diagnosed with Parkinson's disease and 89 of their relatives. A meticulously designed structured interview instrument consisting of 93 items was employed to assess various domains encompassing perceived needs, institutional support mechanisms, essential solutions, and future anticipations. Results: Statistically significant differences were found in health resources, social services resources, obstacles, solutions, and future outlook, with higher mean values from the relatives. Conclusions: The results highlight the most concerning needs in this context. Specifically, those needs related to health resources, social services resources, and future outlook present the greatest differences between the two subsamples, with the family members perceiving more needs. This alignment extended to both the categorization of unmet needs and the requisite solutions envisioned to address them. Suggested improvements include a sociosanitary strategy, stakeholder involvement, and prioritizing flexible home assistance to support older individuals with PD and their families. [ABSTRACT FROM AUTHOR]

Aim: Assessing the indication for elective neuro‐endovascular treatment (EVT) in older patients requires consideration of the impact of systemic comorbidities on their overall reduced life expectancy. The objective of this study was to determine the long‐term outcomes of elective neuro‐EVT in patients aged ≥80 years, and to investigate the impact of pre‐existing cancer on their long‐term outcomes. Methods: Of the patients enrolled in multicenter observational registry, those aged ≥80 years undergoing elective neuro‐EVT between 2011 and 2020 were enrolled. A history of cancer was defined as a pre‐existing solid or hematologic malignancy at the time of EVT. The primary outcome was time to death from elective neuro‐EVT. Results: Of the 6183 neuro‐EVT cases implemented at 10 stroke centers, a total of 289 patients (median age, 82 years [interquartile range 81–84 years]) were analyzed. A total of 58 (20.1%) patients had a history of cancer. A total of 78 patients (27.0%) died during follow up. The 5‐year survival rate of enrolled patients was 64.6%. Compared with patients without a history of cancer, those with a history of cancer showed significantly worse survival (log‐rank test, P = 0.001). Multivariate Cox proportional hazards analysis showed history of cancer was an independent predictor of time to death from elective neuro‐EVT (HR 1.74, 95% CI 1.01–3.00, P = 0.047). Cancer was the leading cause of death, accounting for 25.6% of all deaths. Conclusions: The present study showed that history of cancer has a significant impact on time to death from elective neuro‐EVT in patients aged ≥80 years. Geriatr Gerontol Int 2024; 24: 211–217. [ABSTRACT FROM AUTHOR]

Background & Aims: The burden of metabolic dysfunction‐associated steatotic liver disease (MASLD) is growing rapidly, as is the number of older adults globally. However, relatively few studies have been performed evaluating the prevalence and risk factors for MASLD in older adults. As such, we aimed to identify the prevalence of MASLD in older adults, as well as sociodemographic, clinical, functional and biochemical associations. Methods: The study population included older adults without a history of cardiovascular disease, dementia or independence‐limiting functional impairment who had participated in the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial. MASLD was defined using the Fatty Liver Index (FLI). Associations were identified using Poisson regression with robust variance for FLI ≥ 60 vs FLI < 30. Results: 9097 Australian participants aged ≥70 years had complete biochemical and anthropometric data to identify MASLD. The study population had a mean age of 75.1 ± 4.3 years and was 45.0% male. Almost one‐third (33.0%) had prevalent MASLD, and the prevalence decreased with increasing age (adjusted RR [aRR] 0.96, 95% CI: 0.96–0.97). MASLD was also negatively associated with social advantage (aRR 0.94, 95% CI: 0.90–0.99) and exercise tolerance and was positively associated with diabetes mellitus (aRR: 1.22, 95% CI: 1.16–1.29), hypertension (aRR: 1.31, 95% CI: 1.22–1.41), male sex (aRR: 1.66, 95% CI: 1.57–1.74), pre‐frailty (aRR: 1.99, 95% CI: 1.82–2.12) and frailty (aRR: 2.36, 95% CI: 2.16–2.56). MASLD and nonalcoholic fatty liver disease (NAFLD) results were 100% concordant. Conclusion: This study in a large cohort of relatively healthy community‐dwelling older adults shows that MASLD is common, decreases with age and is associated with poorer metabolic health, social disadvantage and frailty. [ABSTRACT FROM AUTHOR]

Background: Pilocytic astrocytoma (PA) is a benign glial tumor predominately seen in pediatrics and early adolescence with associated overall good outcomes. Very few cases of elderly PA have been reported in the literature, and they are known to display unique anatomic, histologic, and genetic peculiarities distinct from pediatric disease. We report a rare case of vermian PA in an octogenarian with recurrent spontaneous intratumoral hemorrhage as a presenting symptom. Furthermore, a review of the literature on the peculiarities of PA in the elderly will be discussed. Case Description: An 81-year-old woman presented with features suggestive of repeated posterior fossa hemorrhages characterized by headaches, diplopia, and alteration in sensorium occurring about 5 months apart. Brain neuroimaging showed a cerebellar vermian tumor with features suggestive of repeated intratumoral bleeding. She had an initial ventriculoperitoneal shunting for acute hydrocephalus and subsequently had a suboccipital craniotomy and subtotal tumor excision due to morbid adherence to the brainstem. The histologic diagnosis was PA with Ki-67 <1% and negative for isocitrate dehydrogenase-1. There was a slow but progressive clinical improvement, and she has remained symptom-free for 4 years on follow-up. Conclusion: PA in the elderly is a rare disease with distinct histologic and genetic peculiarities. This case review showed one of the oldest cases of cerebellar vermian PA presenting with recurrent spontaneous intratumoral hemorrhage, an extremely rare occurrence in benign glioma. Although complete surgical excision is recommended, partial resection is advocated for morbidly adherent tumors. Overall prognosis is worse in elderly PA. [ABSTRACT FROM AUTHOR]

La maladie d'Alzheimer et les maladies apparentées entraînent des troubles de l'humeur et des troubles anxieux chez les résidents institutionnalisés. La thérapie par réminiscence a démontré un intérêt dans le traitement de ces symptômes. L'étude pilote randomisée « Réminiscences et Émotions » utilise la réalité virtuelle personnalisée pour diminuer les troubles de l'humeur des résidents. Les objectifs secondaires visent à évaluer l'acceptabilité du dispositif et la qualité de vie des résidents. Monsieur G. présente des troubles cognitifs modérés ainsi que des troubles de l'humeur. Il participe à dix séances de réalité virtuelle personnalisée pendant une période de six semaines. Les variables sont mesurées en amont et à la fin du protocole. Une analyse visuelle des scores illustre les résultats. Le dispositif de réalité virtuelle est accepté et toléré par le participant. Les scores aux échelles de l'humeur (dépression, apathie) et de l'anxiété diminuent. Aucune différence n'apparaît sur l'échelle de qualité de vie. Les interventions génèrent du plaisir et de la vivacité en lien avec l'émergence de souvenirs positifs. Il existe un intérêt de la thérapie par réminiscence en réalité virtuelle pour améliorer l'humeur du participant. Les futurs résultats permettront de conclure sur la méthode et son indication thérapeutique en institution gériatrique. The World Health Organization defined dementia as a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological aging. Currently, 55 million people live with Alzheimer's in the world. Unfortunately, there isn't any drug treatment to cure the degenerative disease although clinical trials are promising regarding the use of monoclonal antibodies. But, Alzheimer's disease and associated diseases lead to behavioral and psychological symptoms (anxiety, apathy, depression) which can be frequent in nursing homes. In the context of pandemic, these conditions are amplified because of the sanitary restrictions. Since the beginning of the sars-cov2 pandemic, residents have felt alone, sad and more anxious. Nowadays, non-drug interventions are recommended by health organizations for the treatment of behavioral and mood disorders in the elderly with cognitive disorders. Reminiscence therapy is a non drug intervention which has been shown to be effective in the treatment of mood disorders on elderly. Many nursing homes use this non pharmacological treatment for their residents. Some studies take interest in reminiscence and virtual reality. The use of new technologies is innovative in geriatric care and it can be used as a personalized support for reminiscence therapy. The "Bien Vieillir Nice 2030" Project of Nice's University Hospital supports this research on virtual reality and mood disorders in nursing homes/long term care unit. The objective of this study (University Hospital of Nice, CoBTeK France) is to evaluate the effects of personalized virtual reality on reduction of mood disorders in nursing homes residents with minors and moderates neurocognitive disorders. The secondary objectives are to assess the acceptability of the device, the emotional valence and the resident's quality of life. A single case study is presented to illustrate reminiscences and emotions protocol. Participants are randomized into two groups: neutral versus personalized. The neutral videos consist of unknown places like random streets or public gardens while the personalized videos are known places that mattered to the residents. Places are filmed with a camera GoPro Fusion 360°. The healthcare team and families are actively involved in the research protocol. Their help is invaluable in targeting memories related to the resident's life history. A clinical psychologist specializing in gerontology is in charge of the virtual reality sessions. The therapeutic alliance is central to our study. A humanistic method of person-centered approach allows communication with the resident to offer him to participate in the sessions. The sessions always start and end in the same way in order not to cause stress in the resident. The hardware is tested before the protocol starts, for familiarization purpose. Potential side effects related to virtual reality are identified using a cybermalaise questionnaire. The sessions are held in a sitting position for the participant's safety. In this paper, Mr. G, 92 years old benefits from personalized video according to his life story. He has moderate cognitive impairment as well as mood disorders. He received ten virtual reality sessions over a period of six weeks. The exposure time varies between five to ten minutes. We use an Oculus Rift S headset and a computer in partnership with C2Care. Variables were measured before and at the end of the protocol. We performed a visual analysis of the scores. The results indicated a decrease on mood rating scales scores (Geriatric Depression Scale, Apathy Inventory, Neuropsychiatric Inventory and Hamilton Depression Rating scale). The interventions produced pleasure and alertness in connection along with the emergence of positive memories. The headset was well tolerated by the participant, but we did not observe any effect on quality of life. There is an interest in the use of reminiscence therapy using virtual reality to improve participants' mood. Future results will allow us to conclude on the method and on its indication in nursing homes after the inclusion of 30 participants. [ABSTRACT FROM AUTHOR]

Dans le champ du vieillissement, la recherche actuelle se concentre peu sur l'identité sexuée souvent supposée comme inexistante, notamment dans le très grand âge. Notre objectif est de cibler si elle est encore véritablement opérante, à ce moment, mais aussi de cerner les éventuelles vicissitudes rencontrées. À partir d'un accompagnement psychothérapique réalisé chez une personne nonagénaire en EHPAD, par un psychologue clinicien, sur une durée d'un mois et demi, à la fréquence de deux entretiens hebdomadaires, différentes vignettes ayant une visée descriptive vont retracer ces rencontres. Puis dans l'après-coup, une réflexion nous permet alors de saisir les différentes caractéristiques psychiques exprimées chez cette personne. Certaines modifications peuvent se révéler soudaines et déstabilisantes, relevant davantage d'un trouble éprouvé. En effet, présentant une certaine forme de repli sur soi, le résident va énoncer ne plus se reconnaître dans son identité sexuée avec l'apparition d'un nouvel attrait provoquant une grande souffrance psychique. Celle-ci est d'abord vécue comme intrusive. Elle vient remettre en cause également son rôle social, qu'il soit au sein de sa famille ou encore même dans ses relations amicales et, plus intimement, dans son rapport à lui-même. Le dénouement de cet accompagnement permet de mettre en exergue des mobiles inconscients se manifestant dans ce nouvel attrait. Aging is often perceived as a degenerative process in which the elderly must adapt to a series of degradations. As the population grows older, the field of psychology focuses more on the social and physical aspects of aging than of those of a more psychical nature. In older adulthood, a very particular context appears with the scarcity of social ties, and physical modifications due to advanced age. These bring about profound identity reorganization. However, current aging research focuses little on sexual identity, which is often assumed to be non-existent, especially in old age. Our objective is to examine whether it indeed exists in later adulthood, and if so, to identify the possible trials and tribulations that the elderly encounter therein. This research is based on a clinical case study of a nonagenarian man in a retirement home. A clinical psychologist accompanied the subject over a period of six weeks, with two weekly interviews, the transcriptions of which make up different descriptive vignettes. Afterwards, a reflection allows us to grasp the different psychical characteristics expressed by this resident. Two approaches will guide us in our method of analysis. The first is phenomenological; it remains an interesting reference as it aims to establish an absence of any presuppositions, ensuring a certain neutrality on the part of the researcher, while leaving room for participation in observation and introspection. In addition, succeeding the latter, the method of psychoanalytic inquiry provides the framework for analysis, bringing about a theoretical-clinical articulation to identify and describe the different psychical processes. The words of a nonagenarian man shed light on one of the possible destinies of sexual identification in very old age. Some changes can be sudden and destabilizing, reflecting feelings of confusion. Indeed, presenting a certain form of withdrawal, the resident states that he no longer recognizes himself in his sexual identity with the appearance of a new sexual attraction, causing great psychical suffering. This is first experienced as intrusive. It also calls into question his social identity, both within his family, and even within his circle of friends, and more intimately in his relationship with himself. This therapeutic accompaniment makes it possible to highlight unconscious motives that manifest themselves in this new sexual attraction. The identification of the latter puts an end to this period of confusion, the resident is then able to identify the origin of the episode. The emphasis on certain constants during this trying moment bring about an experience of an identical identity despite what he had thought. This accompaniment concluded with a certain sense of peace and continuity. The clinical setting makes it possible to question the notion of identity, both through psychoanalytic inquiry, and Butler's theoretical conception, which challenges the previous ideas about identity. This theoretical questioning of the clinic enables us to clarify and redefine a possible dynamic of sexual identity in its unconscious perspective. Finally, we put this study in perspective with previous research, and suggest new avenues of investigation to be explored in future studies. [ABSTRACT FROM AUTHOR]

Abstract Aims This paper aimed to explore the views of employers at senior care businesses concerning the employment of retired nurses in Thailand. Design A qualitative interview study was conducted. Methods Face‐to‐face and online semi‐structured interviews with 78 senior care business employers were conducted. Results Business employers had positive sentiments towards employing retired nurses to deliver care and supported them to remain in the profession. Business employers acknowledged that retired nurses have a high level of professional confidence with excellent knowledge and skills. Furthermore, retired nurses were often assigned to work in managerial roles. In addition, flexibility in terms of work hours, suitability of role and responsibilities, and reasonable compensation rates were important to nurses' decisions to remain in or return to the nursing profession. There is a need for the further development of recruitment, retention and reform policies to encourage retired nurses to continue or return to the nursing profession. Patient and Public Contributions We thank all participants for their valuable input throughout the study.

Background: Life-style is one of the most important factors affecting health, which can counteract with various pathogenic risk factors through identification and management of it. Objectives: This study aimed to compare life-style of elders affected and not affected by intestinal parasitic infections (IPIs). Methods: This case-control study was conducted on 190 elders aged ≥60 years old (30 individuals: affected, 160 individuals were non-affected by IPI) who referred to health centers in Gilan province (2017-2018). Sampling was random and the samples were transferred from the health centers to the laboratory of the medical school in east of Guilan. Using direct wet smear (microscopic examination), formalin-ethyl acetate concentration techniques and Ziehl Neelson’s stain, stool samples were examined for IPIs. Data were collected using Babak's healthy life-style questionnaire for the elderly and analysed in SPSS v.21 software. Results: The majority of the participants were in the age range of 60-69 years (63.2%) and illiterate (55.8%). Most of the elders had moderate life-style (62.1%). In the significant dimensions (exercise, prevention, nutrition, stress management and total), mean and median score of life-style in elders non-affected by IPI were higher than affected ones (P

Teams and teamwork are not new to the corporate world. Workers within business organizations have long used teams in some projects. Similarly, in Christian churches, the team ministry has been used for various church activities. However, there is limited information about the concept of team ministry among pastors and elders in the Volta Ghana Mission of the Seventh-day Adventist Church. This study aimed to explore and understand the perceptions of church pastors and elders regarding team ministry in the Volta Ghana Mission of Seventh-day Adventists. This qualitative study used a case study design involving three pastors and three elders from three districts in the Volta Ghana Mission. Thematic analysis was used to analyze the transcribed data. The perceptions of pastors and elders revolved around three themes. Based on the findings, the study recommends that collaboration approach, delegation, and motivation should be encouraged in the team ministry of the Volta Ghana Mission.

While the population is ageing rapidly, we are facing an economic crisis that needs a solution. This study with an elderly group in a Southern Thailand rural area found a suggestion model that applies Participatory Action Research (PAR) with "the ager's social capital" and "the Sufficiency Economy Philosophy (SEPP)" to empower seniors in solving their problems and needs. After four years, the group was upgraded to be the national social welfare management partner; their careers became a community enterprise, green products were created, and the elders received community-based management care. [ABSTRACT FROM AUTHOR]

The Wise Eye Elderly Monitoring System, a comprehensive solution for the monitoring and care of elderly people in Sri Lanka, was developed and put into use as part of this study. This system includes monitoring devices and mobile application to reduce the burden on caregivers. The system uses machine learning techniques to enable automatic system activation and deactivation through image classification, assuring user-friendliness and individualized monitoring for each senior. The device also has an automatic accident detection module that uses machine learning techniques to find accidents in real time and identify them, alerting carers who are away from home right immediately by mobile app. Additionally, the system incorporates voice and sound recognition algorithms to improve communication and enable voicebased commands. This functionality will enhance the system's ability to seamlessly identify and classify an incident of emergency based on the voice inputs received. At the very least, the Wise Eye system uses behavioral pattern analysis and machine learning to forecast how active an older person will be, providing details on their daily routines and probable behavioral aberrations. A dataset of real-world scenarios is used to evaluate the system, showing how well it can recognize the elderly, detect accidents, hear spoken commands, and gauge activity levels. The suggested Wise Eye Older Monitoring System offers a clever and thorough solution that increases the older population's safety and well-being while simultaneously lightening the load on caregivers and raising the standard of care delivered. [ABSTRACT FROM AUTHOR]

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Delirium is a common public health concern that significantly impacts older patients admitted to the Emergency Department (ED). This condition is linked to adverse outcomes such as reduced long-term functionality, higher mortality rates, extended hospital stays, and increased medical costs. The identification of risk factors is crucial for the early recognition and management of delirium in ED patients. Aging, cognitive decline, polypharmacy, and sensory impairment are some of the most common general risk factors described in the literature. Although validated delirium assessment tools already exist, they are not practical for the fast-paced ED environment because of their extended evaluation period or specialized training request. Moreover, clear guidance is needed to select the most suitable tool for detecting delirium, balancing between the accuracy and the swiftness required in an overcrowded, high-stress, and understaffed healthcare setting. This narrative review aims to analyze the updated literature on delirium risk factors in older ED patients and focuses on the methods for better screening, managing, and treating this condition in the ED. [ABSTRACT FROM AUTHOR]

Aims: This paper aimed to explore the views of employers at senior care businesses concerning the employment of retired nurses in Thailand. Design: A qualitative interview study was conducted. Methods: Face‐to‐face and online semi‐structured interviews with 78 senior care business employers were conducted. Results: Business employers had positive sentiments towards employing retired nurses to deliver care and supported them to remain in the profession. Business employers acknowledged that retired nurses have a high level of professional confidence with excellent knowledge and skills. Furthermore, retired nurses were often assigned to work in managerial roles. In addition, flexibility in terms of work hours, suitability of role and responsibilities, and reasonable compensation rates were important to nurses' decisions to remain in or return to the nursing profession. There is a need for the further development of recruitment, retention and reform policies to encourage retired nurses to continue or return to the nursing profession. Patient and Public Contributions: We thank all participants for their valuable input throughout the study. [ABSTRACT FROM AUTHOR]

(1) Background: As the worldwide aging population is growing, there is a need to embrace the role of physical activity in the anxiety of older people. Objectives: To analyze anxiety in older people practitioners and non-practitioners of physical activity; (2) Methods: ample composed of 690 older people of both genders, unselected volunteers, residing in Brazil, present (as participants or observers) in selected street races in the state of Rio de Janeiro, Brazil, between 30 October 2019, and 12 March 2020. An instrument composed of the sociodemographic questionnaire and questions from the Beck Anxiety Inventory, BAI, and the Physical Activity Inventory for older people, Baecke-Old. Design: Ex-post-facto observational analytical descriptive research; (3) Results: The average age of the sample was in the range of 65 to 69y, 74% female, 94% completed high school, 69% living with the family, 84% practicing physical activity. Anxiety levels were 26% (without), 35% (mild), 21% (moderate), and 18% (severe). The comparison of anxiety showed a difference between the groups of active and sedentary elderly. Logistic regression analysis considering anxiety (yes or no; dichotomous variable) and physical activity (yes or no; dichotomous variable) and Odds Ratio were performed to identify possible influences of the independent variables PA, gender, marital status, and education on anxiety. Only physical activity was associated with anxiety. (4) Conclusions: The sample data of this research point to the conclusion that physical activity influences anxiety levels with 98% certainty, and it is suggested that it be enriched in the future with different studies with different designs. The older people practitioners of physical activity with a high level of education presented as 26% without, 35% mild, 21% moderate, and 18% severe anxiety. More active individuals are less likely to develop anxiety. [ABSTRACT FROM AUTHOR]

To systematically review the literature regarding the effect of air pollutants on the excess mortality risk among the elderly Chinese. PubMed, Scopus, Web of Science (WOS), and Chinese National Knowledge Infrastructure (CNKI) electronic databases were searched. A standardized data extraction form was used to collect methodological and outcome variables from each eligible study. The effect value was combined with a fixed- or random-effect model, and sensitivity analysis and publication bias test were performed. A total of 26 articles on air pollutants and excess risk (ER) of mortality in the Chinese elderly were identified. Among them, 16, 14, 8, and 8 articles contained PM2.5, PM10, SO2, and NO2 data, respectively. The meta-analysis results showed that the excess risk of mortality in the Chinese elderly associated with per 10 µg/m3 increase in PM2.5, PM10, SO2, and NO2 concentrations was 1.01%, 0.54%, 1.06%and 1.35%, respectively. Sufficient evidence supports that the increase in air pollutants (PM2.5, PM10, SO2, and NO2) will escalate the mortality of the elderly in China. Future research can study two or more air pollution models and the impact of air pollution on elderly mortality rates under different temperatures, duration of exposure, seasons and regions. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to investigate depression, abuse, and neglect in elderly individuals. Methods: The sample of the research consisted of 315 elderly individuals. Data were collected using a personal information form, an elder abuse assessment form, and the Geriatric Depression Scale. Results: Emotional abuse, neglect, economic abuse, physical abuse, and sexual abuse were detected in 51.4%, 35.6%, 21.9%, 3.8%, and 0.03% of the elderly individuals, respectively. It was observed that elderly individuals in the advanced age group (75–95 years) experienced only emotional abuse, while women, single persons, those with low education levels, those without income of their own, and those who could not perform their self‐care experienced both emotional abuse and neglect to a greater extent (P < 0.05). A total of 68.3% of the elderly individuals showed symptoms of depression at a significant level. The elderly individuals who were exposed to physical and emotional abuse and neglect had higher mean depression scores compared to those who were not (P < 0.05). Conclusions: The study showed that the severity of depression and prevalence of emotional abuse, neglect, financial abuse, and physical abuse were high among older adults. Mental health professionals have a very critical role in recognizing, detecting, and managing elder abuse and they should investigate elder abuse by integrating it into routine screening, especially in high‐risk populations. It is recommended that guidelines for the detection and treatment of abuse and neglect be prepared and implemented. [ABSTRACT FROM AUTHOR]

Elders have a higher rate of return visits to the emergency department (ED) than other patients. It is critical to understand the risk factors for return visits to the ED by elders. The aim of this study was to determine the factors associated with return visits to the ED by elders. This study retrospectively reviewed the hospital charts of elders who returned to the ED within 72 h after discharge from ED. The risk factors identified in the Triage Risk Screening Tool were applied in this study. Of the elders discharged from the ED, 8.64% made a return visit to the ED within 72 h. The highest revisit rate occurred within 24 h after discharge. Factors associated with return ED visits within 24 h by elders were difficulty walking and having discharge care needs. The factor associated with ED return visits within 24–48 h was polypharmacy. Difficulty walking, having discharge care needs, and hospitalization within the past 120 days were associated with return visits made within 48–72 h following discharge. Identifying the reasons for return visits to the ED and providing a continuous review of geriatric assessment and discharge planning could reduce unnecessary revisits. [ABSTRACT FROM AUTHOR]

ObjectiveGeriatric depression is difficult to treat and frequently accompanied by cognitive complaints that increase risk for dementia. New treatment strategies targeting both depression and cognition are urgently needed.MethodsWe conducted a 6-month double-blind placebo-controlled trial to assess the efficacy and tolerability of escitalopram + memantine (ESC/MEM) compared to escitalopram + placebo (ESC/PBO) for improving mood and cognitive functioning in depressed older adults with subjective memory complaints (NCT01902004). Primary outcome was change in depression as assessed by the HAM-D post-treatment (at 6 months). Remission was defined as HAM-D ≤6; naturalistic follow-up continued until 12 months.ResultsOf the 95 randomized participants, 62 completed the 6-month assessment. Dropout and tolerability did not differ between groups. Mean daily escitalopram dose was 11.1 mg (SD = 3.7; range: 5-20 mg). Mean daily memantine dose was 19.3 mg (SD = 2.6; range 10-20 mg). Remission rate within ESC/MEM was 45.8% and 47.9%, compared to 38.3% and 31.9% in ESC/PBO, at 3 and 6 months, respectively (χ2(1) = 2.0, p = 0.15). Both groups improved significantly on the HAM-D at 3, 6, and 12 months, with no observed between-group differences. ESC/MEM demonstrated greater improvement in delayed recall (F(2,82) = 4.3, p = 0.02) and executive functioning (F(2,82) = 5.1, p = 0.01) at 12 months compared to ESC/PBO.ConclusionsThe combination of memantine with escitalopram was well tolerated and as effective as escitalopram and placebo in improving depression using HAM-D. Combination memantine and escitalopram was significantly more effective than escitalopram and placebo in improving cognitive outcomes at 12 months. Future reports will address the role of biomarkers of aging in treatment response.

Introduction: The Indian population experiencing rapid ageing. By 2050, elderly would be 19.5% of the total population. The increasing elderly in society brings with new social problems having tremendous health impact. Elder abuse is a serious but neglected social problem that has adverse consequence on health. Objective: To measure the prevalence of elder abuse and to determine associated factors of elder abuse. Method: A community based cross sectional study was conducted among elderly population aged 60 years and above in the Piparia village of Vadodara district. A sample of 126 study participants were nterviewed to collect data on prevalence of abuse and associated factors leading to abuse. Descriptive and inferential statistics were applied to draw conclusion from collected data. Results: Prevalence of elder abuse was found to be 28.57%. Emotional abuse was the commonest type of abuse reported. Socio economic status, family type, Tobacco use (Smoke and smokeless) were found to be significantly associated with elder abuse. Conclusion: Elder abuse is prevalent in rural Gujarat. Further evidence is needed to assess the magnitude of the problem and the type of intervention necessary to resolve it.

The aging of the population has become gradually deepened in China. The aged care services system should focus on the disabled elders. However, past studies have not yet explored in ⁃ depth about depression among the elderly caused by disability. The study aims to estimate the impact of disability on depression among elderly population by the Instrumental Activity of Daily Living based on CFPS2018 survey data and analyze its heterogeneity effect. Secondly, the study employs the mediation between personality traits and cognitive ability. Thirdly, the study analyzes the moderating effect of social support and social participation. The robustness test indicated a significant negative correlation between IADL and depression among the elderly. In addition, three personality traits and mathematical reasoning ability show significant mediating effects. The regional and demographic factors show significant heterogeneity between East and West, gender, education level and age. Therefore, this study suggests improving the assessment and monitoring system for disability and cognition among elderly population, setting up the early warning mechanism of mental health for focus groups of particular personality traits and cognition, and improving the construction of mental health medical services in the primary public health system. This study also recommends that the government utilizes long ⁃ term care insurance, which plays a vital role in the mental health of disabled elders at the institutional level, while also promotes Smart Senior Care services to enhance the social participation of the elderly. [ABSTRACT FROM AUTHOR]

The lack of standard diagnostic criteria in elder patients with heart failure (HF) makes it challenging to diagnose and manage malnutrition. We aimed to explore the prevalence of malnutrition, its associations and prognostic significance among elder patients with HF using four different nutritional scoring systems. Consecutively presenting patients aged ⩾65 years, diagnosed with HF, and admitted to HF care unit of Fuwai Hospital CAMS&PUMC (Beijing, China) were assessed for nutritional indices. In total, 1371 patients were enrolled (59.4% men; mean age 72 years; median NT-proBNP 2343 ng/L). Using scores for the prognostic nutritional index (PNI) ≤38, controlling nutritional status (CONUT) score >4, geriatric nutritional risk index (GNRI) ≤91, and triglycerides, total cholesterol, and body weight index (TCBI) ≤1109, 10.4%, 18.3%, 9.2%, and 50.0% of patients had moderate or severe malnutrition, respectively. There was a strong association between worse scores and lower body mass index, more severe symptoms, atrial fibrillation, and anemia. The mortality over a median follow-up of 962 days (interquartile range (IQR): 903–1029 days) was 28.3% (n = 388). For those with moderate or severe condition, 1-year mortality was 35.2% for PNI, 28.3% for CONUT, 28.0% for GNRI, and 19.1% for TCBI. Malnutrition, defined by any of the included indices, showed added prognostic value when incorporated into a model and included preexisting prognostic factors (C-statistic: 0.711). However, defining malnutrition by the CONUT score yielded the most significant improvement in the prognostic predictive value (C-statistic: 0.721; p < 0.001). Malnutrition is prevalent among elder patients with HF and confers increased mortality risk. Among the nutritional scores studied, the CONUT score was most effective in predicting the mortality risk. URL: ClinicalTrials.gov ; Unique Identifier: NCT02664818. • The prevalence of malnutrition, as assessed by PNI, CONUT, GNRI, and TCBI, was investigated in elder patients with HF. • Malnutrition is associated with worse prognosis regardless of the screening tools and levels of NT-proBNP or body mass index. • Worse nutrition status is at higher risk of mortality, and CONUT score had the greatest incremental value in predicting risk. • Our research might has the biggest sample focusing on the nutrition state of elder patients with HF in China (1371 patients). • The findings add new evidence of the association between the nutrition status and outcome in elder patients with HF. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disproportionately affected Native American people and communities across the United States. Despite unequal losses during the pandemic, Native Americans have high vaccination rates. We provide insight into perspectives of COVID-19 and vaccinations through in-depth interviews with Native Americans. Through this research, we provide a holistic view of how Native Americans perceive vaccines by pairing Indigenous perspectives of risk and the Health Belief Model. We discuss the importance of tribal sovereignty in developing health communication strategies, and the need for messaging that is trusted and culturally appropriate. [ABSTRACT FROM AUTHOR]

Background We compare the differences in the efficacy of percutaneous transforaminal endoscopic diskectomy (PTED) between the younger (age <60 years) and older (age ≥60 years) patients with lumbar disk herniation (LDH). Methods From December 2016 to December 2017, 128 patients with symptomatic LDH underwent PTED and were followed up. Forty-four 60 years old and above, including 19 males and 25 females with an average age of 68.7 (61–82) years, were classified as the elderly age group. Eighty-four patients younger than 60 years were classified as the young age group, which included 48 males and 36 females with an average age of 44.7 (16–58) years. The visual analog scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and satisfaction rates of the two groups before and after surgery were compared. Results The operation was completed successfully in both groups. The average follow-up times of the elderly and young age groups were 18.47 ± 2.62 (12–23) and 17.90 ± 3.27 (12–23) months, respectively. One patient in the young age group had recurrence 7 months after surgery, and the symptoms were relieved after PTED was performed again. Two patients with nerve root injury after surgery in the young age group completely recovered after 2 months of conservative treatment. There were no significant surgical complications in the elderly age group. There was no significant difference in postoperative VAS, JOA, and MacNab scores between the two groups. The MacNab scores in the elderly age group were excellent for 28 patients, good for 10 patients, and fair for 6 patients; the satisfaction rate was 86.3%. In the young age group, scores were excellent for 63 patients, good for 14 patients, fair for 5 patients, and poor for 2 patients; the satisfaction rate was 91.7%. Conclusion The clinical effectiveness of PTED for treatment of LDH in both elderly and young patients is satisfactory. Age is not a predictor of poor outcomes of PTED. [ABSTRACT FROM AUTHOR]

Background: The relationship between the ratio of blood urea nitrogen to creatinine (BUN/Cr) and physical frailty in elderly patients remains unclear. The study aims to investigate the association between the BUN/Cr ratio and physical frailty in the elderly Chinese population. Methods: In this cross-sectional analysis, the clinical data of 5213 participants from 2015 were selected from the China Health and Retirement Longitudinal Study (CHARLS). The demographic variables (including age and gender) and health behavior (including smoking and drinking history), anthropometric (including systolic and diastolic blood pressure, waist circumference (WC), etc.), physical performances (i.e., grip strength, repeated chair stands, etc.), and biochemical indicators (i.e., blood urea nitrogen (BUN), creatinine(Cr), total cholesterol (TC), triglycerides (TG), etc.) were measured. The association between the BUN/Cr ratio and physical frailty was analyzed. Results: After adjusting for potential confounding factors, smooth curve fitting showed a linear relationship between the BUN/Cr ratio and grip strength, a non-linear relationship between the BUN/Cr ratio, and repeated chair-rising time. The fully adjusted linear regression results showed a negative association between the BUN/Cr ratio and grip strength. In the multivariate, piecewise linear regression, when the BUN/Cr ratio was greater than 18.60, the repeated chair-rising time increased with the increase in BUN/Cr ratio (β = 0.046, 95%CI 0.025, 0.066; p < 0.001). However, we did not observe a significant correlation when the BUN/Cr ratio was less than 18.60 (β = −0.007, 95%CI −0.046, 0.032; p = 0.717). Conclusion: This study demonstrated that the BUN/Cr ratio might be associated with physical frailty in older-aged Chinese, and this association requires further investigation. [ABSTRACT FROM AUTHOR]

Cognitive decline and constipation are common complications in the elderly. Probiotics are potential therapeutic agents to ameliorate cognitive impairment through gut-brain axis. Several clinical studies have investigated the beneficial effects of probiotics on cognitive impairment and constipation in elderly. However, a quantitative meta-analysis is required to evaluate the efficacy of probiotics on cognitive function and constipation. Thirteen clinical studies were included in this meta-analysis. We examined the risk of bias assessment and heterogeneity of eight studies for cognition and five studies for constipation, followed by group and subgroup meta-analyses using a random-effects model to evaluate the potential of probiotic supplements on cognition function and constipation in aged people. The results of the pooled meta-analysis revealed that probiotic supplementation did not improve the cognitive rating scale assessment for all studies (estimate = 0.13; 95%CI [-0.18, 0.43]; p = 0.41; I2 = 83.51%). However, subgroup analysis of single strain supplementation showed improved cognitive function in elderly people (estimate = 0.35; 95%CI [0.02, 0.69]; p = 0.039; I2 = 19.19%) compared to multiple strains. Probiotics also enhanced defecation frequency in constipated patients (estimate = 0.27; 95%CI [0.05, 0.5]; p = 0.019; I2 = 67.37%). Furthermore, probiotic supplementation resulted in higher fecal Lactobacillus counts than placebo (estimate = 0.37; 95%CI [0.05, 0.69]; p = 0.026; I2 = 21.3%). Subgroup analysis indicated that a probiotic intervention period of ≥4 weeks was more effective (estimate = 0.35; 95%CI [0.01, 0.68]; p = 0.044; I2 = 0%) in reducing constipation symptoms than a short intervention duration. Based on these results, probiotic supplementation could be a potential intervention to reduce constipation symptoms in the elderly population. The heterogeneity between studies is high, and limited trials are available to evaluate the cognitive function of aged individuals using probiotics. Therefore, further studies are required to determine the effect of probiotics on cognition.

Today, with the increase in the elderly population and life expectancy, the need to use care services for this significant part of the population is increasing [1]. Beliefs, cultures, and social norms among different ethnicities and races are vital in the extent and nature of care. Two types of care exist, informal and formal. According to statistics by the Secretariat of the National Council on Aging, almost 0.2% of the elderly receive formal care. Therefore, a significant percentage of the elderly live with their families. Coresponding author: Kianoush Abdi, E-mail: k55abdi@yahoo.com You can also search for this author in: PubMed, Google Scholar

Yu Wang,1,&ast; Hanning Zha,1,&ast; Xiang Fang,2 Tianjiao Shen,1 Kunyun Pan,1 Jianping Zhang,1 Keqiang He,1 Sheng Wang,1 Liguo Hu1 1Department of Anesthesiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China; 2Department of Anesthesiology, Hefei BOE Hospital, Hefei, Anhui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Sheng Wang; Liguo Hu, Email iamsheng2020@ustc.edu.cn; hulg@163.comObjective: The dose selection of ropivacaine for spinal anesthesia in clinical work mainly depends on the experience of the anesthesiologist. In this study, a prospective and modified up-down sequential allocation design was used to provide the optimal dose selection of ropivacaine for spinal anesthesia.Patients and methods: This study was divided into two stages, and a total of 164 elderly patients with elective hip fractures were included. In stage I, the dose of ropivacaine was selected using the up-down sequential method of height correction, and the 50% effective dose (ED50) and 95% effective dose (ED95) were obtained. A nomogram for predicting satisfactory anesthesia and a formula for predicting the optimal dose was also given in this stage. In stage II, the dose of ropivacaine was calculated by using the optimal dose prediction formula, so as to evaluate the efficacy and safety of the model.Results: The ED50 and ED95 of the stage I were 7.036 mg (95%CI 6.549– 7.585 mg) and 8.709 mg (95%CI 7.902– 14.275 mg), respectively. And provided a nomogram predicting satisfactory anesthesia with a C-index of 0.847 (95%CI 0.774– 0.92). The optimal dose prediction formula of ropivacaine was calculated, including variables for age, gender, height, and weight. This formula was found to be 90% efficient. It is worth mentioning that the incidence of direct transfer to the ward in the two stages was as high as 86.84% and 93.33%, respectively, and no patients were transferred to the ICU in stage II.Conclusion: The ED50 and ED95 of ropivacaine were 7.036 mg and 8.709 mg, respectively, and the nomograms are sufficiently accurate to predict satisfactory anesthesia. Beyond that, the dose prediction equation provided in this study has high efficacy and safety, and can guide the dose selection of spinal anesthesia in elderly patients with hip fracture in clinical practice.Clinical trials registration: ChiCTR2100046982Keywords: ropivacaine, dose selection, elder, spinal anesthesia, Hip fracture, sequential design

Abstract Background COPD combined with respiratory failure is very common in intensive care unit (ICU). We aimed to evaluate the current status and influencing factors of delirium in elderly COPD patients with undergoing mechanical ventilation. Methods Patients with COPD combined with respiratory failure and mechanically ventilated who were admitted to the ICU of our hospital were selected. The characteristics of included patients were assessed. Pearson correlation analysis was performed to evaluate the characteristics of patients and delirium. Logistic regression analysis was conducted to identify the risk factors of delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation. Results A total of 237 COPD combined with respiratory failure patients were included, the incidence of delirium was 21.94%. Pearson correlation analysis indicated that age (r = 0.784), BMI (r = 0.709), hypertension (r = 0.696), APACHE II score (r = 0.801), CPOT (r = 0.513), sedation(r = 0.626) and PaO2 (r = 0.611) were all correlated with the occurrence of delirium (all p