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Biomedical subjects

A Sham

Publications and source records attributed to A Sham.

33 records · Page 2Linked to original sources
PubMed1997

Predictors of mobility decline: the Hong Kong old-old study.

BACKGROUND: Old age is often accompanied by functional decline and loss of autonomy. This longitudinal study examines the factors associated with mobility decline among a Chinese elderly cohort aged 70 years and above. METHODS: Analyses were carried out on data collected from 1,483 elderly subjects who were functionally mobile at baseline and survived the 18-month follow-up period. The outcome variable "mobility decline" was measured using the Barthel Activities of Daily Living Scale, which accesses subjects' ability to be independent in walking a distance of 50 meters and/or moving up and downstairs during the 18-month follow-up interview. RESULTS: Multivariate backward stepwise logistic regression analysis revealed that the following baseline characteristics were independently associated with mobility decline during the follow-up period: increasing age (OR 1.4, 95% CI 1.2-1.6 for every 5-year increase in age), no formal level of education (OR 1.9, 95% CI 1.0-3.9), no current practice of exercise (OR 2.1, 95% CI 1.4-3.1), symptoms of palpitation (OR 1.7, 95% CI 1.1-2.8), body mass index [weight (kg)/height (m)2] below 20 (OR 1.7, 95% CI 1.1-2.6), and slow gait velocity (OR 1.12, 95% CI 1.09-1.16 per second increase in gait time). There was also significant association between the experience of falls during follow-up and mobility decline (OR = 2.9, 95% CI = 1.9-4.5). CONCLUSION: Low body weight, lack of exercise, and falls during the follow-up period might serve as markers as to which subjects are at risk for mobility decline.

Accidental Falls↗
PubMed1996

Dietary calcium intake, physical activity and the risk of vertebral fracture in Chinese.

To study the relationship between dietary calcium intake, load-bearing activity, reproductive factors, anthropometric factors and vertebral fracture in Chinese, a case-control study was carried out on 481 women (aged 70-79 years) who lived in three housing blocks under the Geriatric Priority Housing Scheme in Shatin, Hong Kong. Lateral spine radiographs were taken from the T4 to L4 level. Definite and doubtful vertebral fractures were diagnosed when any of the three vertebral height (anterior to anterior, middle to posterior and posterior to posterior) ratios was 3 SD and 2-2.99 SD below the mean respectively. Women with one or more definite fractures were classified as definite cases, those with one or more doubtful fractures were classified as doubtful cases, and the rest as controls. The mean dietary calcium intake and load-bearing activities were obtained by interview, using a structured questionnaire. Detailed information on cigarette smoking, alcohol consumption and reproductive factors was also obtained. The grip strength, body weight and height were measured. Doubtful cases were found to differ little from the controls in their lifestyle and anthropometric factors. The odds ratio (OR) for being a definite case was 2.1 (95% CI = 1.1-3.9) when the dietary calcium intake was in the lowest quartile. The OR was 1.8 (95% CI = 0.8-4.4) for subjects who walked or exercised outdoors for less than an hour a day. Giving birth to or breast-feeding three children or more was protective against definite fracture. The definite cases were significantly lighter and shorter than controls; they also had a weaker grip strength. It is concluded that a low dietary calcium intake was significantly associated with an elevated risk of vertebral fracture, while the effect of infrequent load-bearing activity was uncertain. Giving birth to or breast-feeding three or more children was protective against vertebral fracture in our population.

Aged↗
PubMed1996

Body composition and bone mineral density of Chinese women with vertebral fracture.

This study was designed to compare the body composition and bone mineral density measurements (BMD) in Chinese women with vertebral fracture and normal controls. A total of 400 community dwelling Chinese women aged 70-79 years old were studied. Vertebral height ratios were calculated from lateral thoracic and lumbar spine X-rays and subjects were classified into definite cases (n = 122), doubtful cases (n = 138) and normal controls (n = 140). Bone mineral density and body composition measurements were made by dual X-ray densitometry. The height, fat mass, lean mass, and BMD at all sites were significantly lower in patients with definite fracture than normal controls. Nevertheless, BMD at the hip was more predictive of vertebral fracture than BMD at the spine, the odds ratio in the lowest quartile of hip BMD being 3.8 (95% C.I. = 1.3 to 10.9). Finally, the extent of spinal deformity was poorly predicted by a combination of the anthropometric and BMD measurements, as only 12% of the total variance in TD1 was accounted for.

Absorptiometry, Photon↗
PubMed1996

Risk factors for falls in the Chinese elderly population.

BACKGROUND: Besides being the major cause of hip fracture, falls also have important consequences in injuries and mortality, especially in the elderly population. This study investigated the occurrence of and the correlates of falls in a cohort of Hong Kong Chinese elderly aged 70 years and above. METHODS: The research was based on the baseline cross-sectional study of an age- and sex-stratified cohort consisting of 1,947 ambulatory subjects. The occurrence of falls was based on the previous 12 months. Logistic regression analysis was used to test the effect of each independent variable, adjusting for age and sex. Multivariate logistic regression analysis based on the backward elimination procedure was used for the final model. RESULTS: Previous white-collar employment, poor self-perceived health, dizziness, slow gait velocity, difficulties in activities of daily living, non-practice of "morning walk," body mass index in the range of 20-24, use of local skin preparation, and presence of cerebrovascular disease were independently associated with falls. Smokers were found to have an independent decreased risk of falls. Neither age nor sex was significantly associated with falls after adjusting for the other explanatory variables. CONCLUSIONS: The results from this population-based cross-sectional study form a basis for further prospective study on falls in the Chinese elderly population. Both intrinsic and extrinsic factors including circumstances and consequences of falls are important considerations in the strategy for the prevention of falls.

Accidental Falls↗
PubMed1996

The prevalence of and risk factors for neck pain in Hong Kong Chinese.

BACKGROUND: Neck pain has been found to be a prevalent musculoskeletal complaint among Caucasians living in Europe and North America. The prevalence of and risk factors for this condition have not been studied among Chinese living in urbanised cities. The objective of this study was to describe the prevalence of and risk factors for neck pain in Hong Kong Chinese. METHODS: A household survey was conducted in two housing blocks, one being government-subvented housing and the other being private housing. Eight hundred men and women who were 30 years and older were interviewed on the occurrence and characteristics of neck pain, occupations and recreational activities. The life-time and one-year prevalence of neck pain were calculated, and the odds ratio (OR) and 95 per cent confidence intervals (95 per cent CI) for various risk factors were derived by logistic regression. RESULTS: The one-year prevalence of neck pain was 15 per cent and 17 per cent in men and women, respectively. The OR was 1.6 (95 per cent CI = 1.2-2.4) for living in private housing and 2.1 (95 per cent CI = 1.1-4.0) for working as managers and professionals. Subjects with neck pain spent more time reading and a history of trauma to the neck was a significant risk factor for subsequent pain (OR = 5.6, 95 per cent CI = 3.3-9.4). CONCLUSION: Neck pain is a prevalent problem in Hong Kong Chinese, particularly among subjects of a high socioeconomic status. There was little association between life-style and neck pain, although subjects with neck pain spent more time in reading.

Adult↗
PubMed1996

Tuberculosis among elderly Chinese in residential homes: tuberculin reactivity and estimated prevalence.

Objectives of this study were to determine the prevalence of positive tuberculin reactivity and associated factors among elderly nursing home residents in a population with a relatively high tuberculosis notification rate, to estimate the prevalence of active tuberculosis, and to assess tuberculin reactivity as a screening tool. A stratified, disproportional, randomized cluster sample of residents was selected and the Mantoux test (using 0.1 ml of 5 tuberculin units of purified protein derivative of tuberculin) carried out. All subjects with a positive test had a chest X-ray followed by sputum smear and culture if the X-ray was abnormal. Sputum examination was also carried out in a random sample of controls, matched for age and gender, drawn from subjects with a negative Mantoux test. Information regarding medical history, tobacco smoking habits, symptoms related to tuberculosis, and communal eating habits were gathered. Also anthropometric data were collected. Sixteen nursing homes in the catchment area of a major district hospital in Hong Kong comprising 587 residents (136 men, 451 women, mean age 80 +/- 8 years) participated in this study. The weighted prevalence of tuberculin reactivity was 43.8%. It was higher in men, among those who took their meals in a common area, in the younger age group, and in those with no previous history of hospitalization. No association was found between prevalence and duration of residence, smoking, skinfold thickness, past medical history, or any relevant symptoms. Following radiological and sputum examination, the estimated prevalence of active tuberculosis ranged from 1.2 to 2.6%. The sensitivity of the tuberculin test was 86, the specificity 30%. The prevalence of active tuberculosis in nursing homes in Hong Kong is high, but it is unclear whether cross-infection or poor health of the residents is the major contributing factor. Tuberculin skin testing does not appear to be a useful screening method in this population.

Aged↗
PubMed1995

Influence of age, disease and disability on anthropometric indices in elderly Chinese aged 70 years and above.

To determine the influence of age, disease and other factors on anthropometric indices in elderly subjects aged 70 years and above, body mass index (BMI), arm muscle circumference (AMC), corrected arm muscle area (CAMA), fat-free mass (FFM) and total body fat (TBF) were determined in a random sample of 990 Chinese men and 1,021 women aged 70 years and over stratified by age and sex. Old age, presence of disease, poor self-perceived health, poor functional ability, lower level of physical activity, lack of dentures, depression and cognitive impairment were all factors associated with lower anthropometric values. Haemoglobin, total cholesterol and walking speed were also associated factors, although the latter two factors became insignificant after adjusting for age. When subjects with a history of disease or cognitive impairment were excluded, an age-related decline in BMI, AMC, CAMA and TBF was still observed in men although FFM remained unchanged. However, in women, only TBF showed an age-related decline. It is concluded that in the old-old population, both age and disease affect anthropometric indices, the change being more marked in men.

Adipose Tissue↗
PubMed1994

Risk factor change in older persons, a perspective from Hong Kong: weight change and mortality.

BACKGROUND: The influence of anthropometric measurements on mortality and longevity has been of interest to a number of investigators. However, although such measurements are not stable over time, few studies have attempted to account for such changes in longitudinal studies. The present study attempts to examine the relationship between weight change and mortality outcome. METHODS: The research was based on a longitudinal study of a cohort of 1,056 Hong Kong Chinese men and women aged 70 and above. Among the 476 nonsmoking women at baseline, 374 with weight measurements both at baseline and at 24 months follow-up were included in the study. Proportional hazards analysis with adjustments for age and other physical and social factors was used to estimate the relative risk of mortality of the higher body mass index groups in relation to the lowest body mass index group and between the weight change groups. RESULTS: Women belonging to the middle tertile of body mass index distribution had the lowest mortality. Those with a weight loss of more than 2 kg over the first 24 months follow-up had five times the risk of mortality at 40 months, even after adjusting for health and social conditions and baseline body mass index. CONCLUSION: The results suggest that both the initial body weight and weight change during the follow-up period are important considerations in the study of the association between body weight and mortality.

Aged↗
PubMed1993

Lipid profile in the Chinese old-old: comparison with younger age groups and relationship with some cardiovascular risk factors and presence of diseases.

In a health survey of 2,032 elderly Hong Kong Chinese aged 70 years and over selected by stratified random sampling, a subset of 199 subjects (96 M, 103 F) were selected for a study of their lipid profile. No age and sex differences were observed in mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations in this subgroup. Compared with values from younger Chinese subjects from a previous survey, TC and LDL-C showed an age-related rise up till about 60 years, followed by a gradual decline. HDL-C concentrations showed little variation with age. Nonagenarians had a LDL/HDL ratio similar to subjects in the < 24 age group and lower than male subjects in the age 35-64 age group. HDL-C was lower in those with heart disease or hypertension. Other lipid parameters were not influenced by the presence of other chronic diseases, self-perceived health status, or cognitive impairment. TC was positively associated with the Barthel Index, a measure of functional ability. Positive associations between obesity indices and diastolic blood pressure, and TC, LDL-C, and triglycerides were present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Blood pressure and 40 month mortality in elderly Chinese subjects aged 70 years and over.

The association between blood pressure and 4 year mortality was examined in a cohort of 970 Chinese subjects aged 70 years and above. After adjusting for age, sex, body mass index, smoking habit, place of residence, and the presence of heart or chronic lung diseases, a U-shaped association between blood pressure and mortality was observed, the risks of mortality among subjects in the extreme quartiles being twice as high as those in the middle quartiles. Subjects with the lowest systolic blood pressure quartile also had a higher risk of developing functional limitations.

Aged↗
PubMed1990

Open pelvic fractures.

We reviewed 32 patients with open pelvic fractures treated over a 5-year period. Eleven patients had isolated fractures of the ilium and in 21 patients pelvic ring disruption was associated with a perineal laceration. Three patients died from massive haemorrhage soon after admission and one patient from severe sepsis. Early pelvic stabilization and meticulous attention to the soft tissue injury proved invaluable in the management of open unstable pelvic fractures.

Adolescent↗
PubMed1988

Psychosomatic symptoms, social support and self worth among the elderly in Hong Kong.

A prospective study to test the relationship between social support and health outcomes among the 1000 elderly Chinese subjects aged 70+ is being carried out in a Hong Kong New Town. This paper reports on the study factors related to psychosomatic complaints based on the first phase cross sectional data. Logistic regression analysis shows that being female, living in institutions, having a low level of social support and a low level of self worth independently increased the risk of developing a high level of psychosomatic symptoms. The relative risks for these factors range from 1.4 to 1.9 and all were significantly different from unity.

Aged↗
PubMedDate not supplied

Social determinants of frailty.

BACKGROUND: Frailty represents a body-wide set of a linked deterioration that occurs with ageing, but is susceptible to active intervention and is reversible. The concept of frailty should include broader environmental factors. A quantitative measure of frailty, the frailty index (FI), developed for elderly Canadians and shown to be valid for an elderly Chinese population, was examined for its association with socioeconomic, lifestyle, and social support network factors in an elderly Chinese cohort. OBJECTIVE: 2,032 people aged 70 years and over recruited by stratified random sampling of the population were surveyed in 1990-1991, and information obtained regarding physical and functional health, psychological factors, lifestyle, socioeconomic and social support factors. The FI was constructed from 62 variables covering cognitive, psychological and physical health, and tested for association with socioeconomic, lifestyle and social support factors using ANOVA and t test. RESULTS: The mean FI for women was higher than for men (0.16 +/- 0.08, n = 1,033 vs. 0.13 +/- 0.08, n = 999, p < 0.001, t test). For men, increasing frailty was observed with non-white collar occupations, inadequate expenses, no or little exercise, abstinence from alcohol, few relatives or neighbours and no or infrequent participation in helping others. For women, little contact with relatives (rather than number of relatives), and absence of participation in community/religious activities were additional factors. CONCLUSION: FI is influenced by social and environmental factors in keeping with the concept of frailty being multi-dimensional. Such a quantitative measure may be a useful indicator of the health of elderly populations as well as for public health measures to combat frailty.

Aged↗
PubMedDate not supplied

Hospital readmission among older medical patients in Hong Kong.

OBJECTIVE: To study the risk factors for hospital readmission among older medical patients in Hong Kong. DESIGN: Cohort study. SUBJECTS: 1,204 consecutive hospital medical patients aged 70 years and over in Hong Kong. PROCEDURES: Subjects were interviewed by a research nurse on discharge, and were followed up for six months. OUTCOME: Unplanned hospital readmissions were identified and classified as avoidable or unavoidable. The risk factors for early (within 28 days), recurrent (three or more) and avoidable readmissions were studied by multiple logistic regression. RESULTS: Four hundred and fifty-five patients (37.7%) had at least one readmission in six months; 18%, 6.4%, and 2.9% of subjects had early, recurrent and avoidable readmissions respectively. Recent hospital stay predicted all types of readmissions. Early readmission was predicted by length of stay, Barthel index (assessment of physical and mental function) and unresolved medical problems. Recurrence readmission was predicted by poor family support, residence in a home for the elderly and unresolved medical problems. CONCLUSIONS: Hospital readmission may be prevented by ensuring adequate length of stay, so that medical problems are resolved before discharge.

Aged↗