Xuemei Zhang

Background: Decreased masticatory function contributes to malnutrition in the elderly. The purpose of our study was to explore whether the masseter muscle is involved in masticatory function in older adults and to help determine if the masticatory function of the elderly can be improved by exercising the masseter muscle. Methods: Random sampling was adopted in our research, and a total of 413 older adults from 9 nursing homes in China were recruited from March 10 to June 12, 2022. The thickness and echo intensity of their masseter muscles were assessed using ultrasound. Masticatory function was measured using a color-changing chewing gum, and the change of α* before and after chewing (Δα*) was defined as masticatory function. If Δα* Results: Of the 413 older adults, 179 (43.3%) had masticatory dysfunction. The average thickness of the masseter muscle between contraction and relaxation was 1.3 mm (range, 0.7–2.0 mm). The thickness of the masseter muscle and ODK decreased with age, while the echo intensity of the masseter muscle increased. The results of the multiple linear regression analysis showed that dynamic change in the thickness of the masseter muscle between contraction and relaxation (β=0.085; P=0.049), MTP (β=0.147; P=0.001) and MOSN (β=0.349; PConclusions: We found that masticatory dysfunction was prevalent among older adults in nursing homes in Southwest China, and the dynamic change in the thickness of the masseter muscle between contraction and relaxation was positively correlated with masticatory function. This result suggests that we can improve the masticatory function of the elderly by increasing the thickness of the masseter muscle between contraction and relaxation (e.g., by exercising the masseter).

Background: Nurses in hemodialysis (HD) units are the main performers in the maintenance and management of HD patients’ vascular access, and the cognition degree of their specialized knowledge of vascular access directly affects the quality of vascular access management. However, most of the investigations on the cognition of vascular access knowledge take HD patients as the research subjects, while there are few studies on nurses in HD units as the research subjects. Herein, we explored the knowledge of vascular access among HD unit nurses and its influencing factors, aiming to inform the training of HD unit nurses on vascular access management. Methods: By using a convenience sampling method, we investigated the knowledge of vascular access in terms of basic knowledge, vascular access assessment and arteriovenous fistula (AVF) puncture technique knowledge of dialysis unit nurses who volunteered to engage in hemodialysis clinical nursing for more than 6 months in HD units in Sichuan Province from March 2022 to May 2022. Data were collected on demographic characteristics, hospital nature, the city and region where the hospital is located, the working time of hemodialysis. Analysis of variance was used to analyze the score of vascular access specialist knowledge of HD unit nurses, and multiple linear regression was used to explore the influencing factors of vascular access specialist knowledge of HD unit nurses. Results: A total of 222 nurses in HD units were included. The total score of the knowledge of vascular access was 87.52±13.71 points, of which the basic knowledge scored 3.88±0.60 points, the vascular access assessment scored 3.62±0.65 points, and the AVF puncture techniques scored 3.22±0.71 points. Multiple linear regression analysis showed that longer working years [beta: 0.381, 95% confidence interval (CI): 3.064–7.188, P=0.000], more advanced training [beta: 0.206, 95% CI: 2.817–10.672, P=0.001], and public hospital [beta: 0.138, 95% CI: 0.839–12.342, P=0.025] positively predicted higher knowledge of vascular access scores among HD unit nurses (all PConclusions: The cognitive degree of vascular access specialized knowledge of hemodialysis nurses is affected by different working years, training experience and the nature of the hospital. Nursing managers can develop different training and assessment programs for vascular access specialized knowledge according to different influencing factors.

Background: Delirium is a common complication that leads to poor health outcomes in older patients undergoing treatment. Due to severe consequences, early recognition of high-risk patients and risk factors for delirium are crucial in the prompt initiation of prevention measures. However, research in medically hospitalized patients aged ≥80 years remains limited. This study aimed to determine the incidence, predictors and health outcomes of delirium in very old (aged ≥80 years) hospitalized patients in China. Methods: A prospective study was conducted in individuals aged ≥80 years admitted to geriatric departments. Potential risk factors were assessed within 24 h after hospital admission. Screening for delirium was performed on admission and every 48 h thereafter for 14 days and assessed if acute mental status changes were observed. During hospitalization, health outcomes were recorded daily. Results: Incident delirium occurred in 109 of 637 very old hospitalized patients (17.1%). The independent predictors of delirium in hospitalized patients aged 80 and over were cognitive function impairment [OR 17.42, 95% CI:(7.47–40.64)], depression [OR 9.30, 95% CI: (4.59–18.84)], CCI ≥ 5 [OR 4.21, 95% CI: (1.48–12.01)], sleep deprivation [OR 3.89, 95% CI: (1.71–8.82)], infection [OR 3.33, 95% CI: (1.70–6.54)], polypharmacy (≥5 medications) [OR 2.85, 95% CI: (1.51–5.39)], constipation [OR 2.58, 95% CI: (1.33–5.02)], and emergency admission [OR 2.13, 95% CI: (1.02–4.45)]. Patients with delirium had significantly longer hospital stays(P < 0.001) and higher percentages of physical restraint use(P < 0.001) and falls (P = 0.001) than those without delirium,. Conclusion: The incidence of delirium was high in hospitalized patients aged ≥80 years admitted to the geriatric department and was associated with prolonged hospital stay and higher rates of physical restraint use and falls. In this population, the most important independent risk factors for incident delirium were cognitive function impairment and depression. Health care professionals should recognize and initiate interventions for delirium early in geriatric patients.

Background: Dysphagia is common in the elderly population, and it can lead to complications such as aspiration, undernutrition, and psychological and social interaction disorders in the elderly and have a great impact on quality of life. This study aimed to understand the current knowledge, attitudes, and practices (KAP) of geriatric nurses regarding dysphagia care for elderly adults and to analyze the relevant influencing factors to improve care plans for elderly patients with dysphagia. Methods: A multicenter cross-sectional survey of 782 geriatric nurses from 17 hospitals in Sichuan Province was conducted using a questionnaire to determine their KAP regarding dysphagia care. Results: The geriatric nurses’ mean score for geriatric dysphagia-related knowledge was 55.30±0.61 (out of a total score of 100). The results of a univariate analysis showed that the geriatric dysphagia-related knowledge scores differed significantly among the nurses according to their age, education level, title, hospital level, and years of work experience (PConclusions: The geriatric nurses had acceptable practices and attitudes regarding dysphagia care, but their knowledge regarding geriatric dysphagia needs to be enhanced. Hospital administrators should provide targeted training to improve geriatric nurses’ competency in dysphagia care and thus ensure the quality and safety of dysphagia care for elderly patients.

To examine the impact of marital status on overall survival (OS) and rectal cancer-specific survival (RCSS) for aged patients. We used the Surveillance, Epidemiology and End Results database to identify aged patients (>65 years) with early stage rectal cancer (RC) (T1–T4, N0, M0) in the United States from 2004 to 2010. Propensity score matching was conducted to avoid potential confounding factors with ratio at 1:1. We used Kaplan–Meier to compare OS and RCSS between the married patients and the unmarried, respectively. We used cox proportion hazard regressions to obtain hazard rates for OS, and proportional subdistribution hazard model was performed to calculate hazard rates for RCSS. Totally, 5196 patients were included. The married (2598 [50%]) aged patients had better crude 5-year overall survival rate (64.2% vs 57.3%, P < .001) and higher crude 5-year cancer-specific survival rate (80% vs 75.9%, P < .001) than the unmarried (2598 (50%)), respectively. In multivariate analyses, married patients had significantly lower overall death than unmarried patients (HR = 0.77, 95% CI = 0.71–0.83, P < .001), while aged married patients had no cancer-specific survival benefit versus the unmarried aged patients (HR = 0.92, 95% CI = 0.81–1.04, P = .17). Among old population, married patients with early stage RC had better OS than the unmarried, while current evidence showed that marital status might have no protective effect on cancer-specific survival.