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Won C.W.,Kyung Hee University | Yoo H.J.,Geriatric Syndrome Committee | Yoo H.J.,Hallym University | Yu S.H.,Geriatric Syndrome Committee | And 12 more authors.
European Geriatric Medicine | Year: 2013

Objective: Geriatric syndromes are conditions that are highly prevalent, multifactorial, and associated with substantial morbidity and poor outcomes in the elderly. Geriatricians agree on its definition, but the lists of geriatric syndromes vary based on the purpose. The aim of this article is to attempt to reach a consensus on the list of geriatric syndromes within the Asian-Pacific geriatric societies. Methods: We surveyed Asian-Pacific expert geriatricians using a questionnaire that asked whether each country's geriatric society recognized the presented items as a geriatric syndrome. Results: Expert geriatricians from 10 Asian-Pacific nations/regions completed the questionnaire. Dementia, incontinence, delirium, falls, hearing impairment, visual impairment, sarcopenia, malnutri- tion, and frailty were agreed on as geriatric syndromes by all 10 respondents. Immobility, gait disturbance, and pressure ulcers were included as geriatric syndromes by 90% of the respondents while osteoporosis, failure to thrive, sleep disorder, and functional dependency were included by 80%. Less than 50% of the respondents included self-neglect, anorexia, and emesis as geriatric syndromes. Conclusions: Dementia, incontinence, delirium, falls, hearing impairment, visual impairment, sarcopenia, malnutrition, frailty, immobility, gait disturbance, and pressure ulcers were included as geriatric syndromes by at least 90% of the respondents. These lists seem to be consented to be geriatric syndromes in Asian-Pacific geriatric societies. These lists are generally similar to the lists of geriatric syndromes provided by professors from the western world, but with some differences Keywords: Geriatrics Asia Consensus Geriatric syndromes provided by professors from the western world, but with some differences. © 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. Source


Wang J.,Institute for Geriatric Clinic and Rehabilitation | Yin L.,Institute of Medical Informatics | Chen Z.,Institute for Geriatric Clinic and Rehabilitation
Journal of Clinical Gerontology and Geriatrics | Year: 2011

The extracellular matrix (ECM) is a fibrillar meshwork consisting of many long-chain polyelectrolytes, such as glycoproteins (e.g., fibronectin), glycosaminoglycans, and proteoglycans, all of which fabricate an anisotropic microenvironment that bears dynamic and preferential intercellular communication channels, that is, extrasynaptic transmission. Fibronectin is a ubiquitous ECM component, which accumulates to form poriferous perineuronal nets to regulate matrix organization, such as specific binding to growth factor receptors or clearance of degraded products, and directing cell behaviors, including receptor activation that transduces signals into cells, in addition to its supportive and adhesional roles. Integrins are a family of transmembrane glycoprotein receptors for both ECM proteins like fibronectin and neural growth factors like insulin-like growth factor-1, and the binding of fibronectin to integrins transactivates the intracellular signaling events, such as phosphatidylinositol 3-kinase/protein kinase B pathway to regulate or amplify growth factor-like neuroprotective actions. In the aging brain, the fibronectin, integrins, and other ECM proteins are all downregulated, which brings about the altered structural and functional properties (e.g., neurotransmitter storage, clearance of metabolites, and diffusion parameters) of ECM and extrasynaptic transmission and underlies the molecular mechanism of neurodegenerative disorders. In this article, the neurotrophic mechanism of fibronectin and integrins for pathogenesis of Parkinson's disease and Alzheimer's disease is analyzed, involving interaction of integrin and insulin-like growth factor-1 receptor or glial cell line-derived neurotrophic factor receptor, and the potential therapeutic and diagnostic implications of fibronectin are also discussed. © 2011, Asia Pacific League of Clinical Gerontology & Geriatrics. Published by Elsevier Taiwan LLC. All rights reserved. Source


Song Y.,Institute for Geriatric Clinic and Rehabilitation | Wang J.,Institute for Geriatric Clinic and Rehabilitation
Ageing Research Reviews | Year: 2010

Studies of senile dementia (SD) on the Chinese mainland, done over the decades, have furthered the understanding of its epidemiology, basic and clinical medical aspects, and effects on health economics, to name a few areas. There are 6-7 million Chinese people with SD, with an incidence of 5-7% of people over 65 years of age. In this group, Alzheimer's accounts for 50-60% of SD. The pathogenesis of Alzheimer's disease has been investigated, and known risk factors include β-amyloid, formaldehyde, acetyl cholinesterase, inflammation, neuronal dysfunction and death. Mild cognitive impairment (MCI) is an independent risk factor of SD. Comprehensive treatment can improve clinical efficacy, and quality of life can be improved by appropriate and reasonable care and rehabilitation therapy. However, swallowing disorders, infection and systemic failure remain the main causes of death among SD patients. In the Chinese mainland, SD extracts a total annual economic loss of 83.5-97.4 billion yuan and is responsible for 51.3-59.8 billion yuan in annual healthcare costs. Despite the progress to date, basic research and drug development for SD are needed. Also, a more evidence-based approach to Chinese medicine research would be prudent. Such research results can hopefully provide valuable cues for governmental decision-making and assist in addressing and halting the incidence of SD in China. © 2010 Elsevier B.V. Source


Wang J.,Institute for Geriatric Clinic and Rehabilitation | Chen Z.,Institute for Geriatric Clinic and Rehabilitation | Song Y.,Institute for Geriatric Clinic and Rehabilitation
Ageing Research Reviews | Year: 2010

Falls are a common and serious problem for aged people, causing an enormous amount of morbidity, mortality and burden to both the immediate family and the society in terms of healthcare utilization and costs. In the Chinese mainland, epidemiological data indicates a predilection for single falls, with women more at risk than men. A variety of risk factors such as weakness, unsteady gait, mental confusion and use of certain medications are associated with falls in the elderly. Addressing these risk factors can be expected to reduce rates of falling. Targeted fall risk assessments are the most effective preventive procedures, and include a plethora of assessment instruments that have been developed and designed for different purposes over the decades. Strategies for control of elderly falls have been established differently, taking into account the complex physiological and pathological conditions of the elderly. The optimal approach involves interdisciplinary assessments, physical exercise, medical intervention, environmental inspection and hazard abatement. In China, the 25 million falls suffered annually by the estimated 20 million elderly population exacts direct medical costs of about 5 billion yuan and social costs of 60-80 billion yuan. Fall-prevention strategies will thus have profound social and economic benefits. © 2010 Elsevier B.V. Source


Chen Z.,Institute for Geriatric Clinic and Rehabilitation | Song Y.,Institute for Geriatric Clinic and Rehabilitation | Yu J.,U.S. National Institute on Aging | Wang J.,Institute for Geriatric Clinic and Rehabilitation
Journal of Clinical Gerontology and Geriatrics | Year: 2014

Facing the unprecedented ever-increasing healthcare demands of its aging population, Beijing municipal government has been endeavoring to improve the continuity of medical services for the elderly in the People's Republic of China. In this article, a comparison of the healthcare services for the aged in China with those in Japan and Australia was performed, indicating the feasibility in China of the Japanese health insurance policy and Australian geriatric evaluation and management model of care. The problems associated with the current healthcare system for the elderly in Beijing were discovered and analyzed. Possible strategies and specific measures that need to be improved are proposed by analysis and utilization of the personal experiences of Japan and Australia. © 2014, Asia Pacific League of Clinical Gerontology & Geriatrics. Source

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