Human leukocyte antigen associations of epidemic Kaposi's sarcoma.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
J Lau
Publications and source records attributed to J Lau.
Life satisfaction and associated factors in older Hong Kong Chinese.
OBJECTIVE: To determine life satisfaction and its association with physical, functional, socioeconomic, psychological, and social support characteristics in Hong Kong Chinese aged 70 years and older. DESIGN: Cross-sectional study. SETTING: Territory-wide random sample of persons aged 70 years and older. SUBJECTS: A total of 843 men and 714 women were selected by random sampling, stratified by age and sex, from the Old age and Disability Allowance Register, after exclusion of subjects with cognitive impairment. MEASUREMENTS: Life satisfaction was assessed by the subjects' response to the question "Are you satisfied with life", using a 0 to 10-point linear scale. They were also asked to name the most important factor contributing to life satisfaction. Information was also obtained regarding physical health, functional ability, depressive symptoms, and socioeconomic factors. RESULTS: There was a weak association between score and age. Health, adequate income to meet living expenses, and caring relatives were rated the most important factors (> 65%). Some of these factors were also those associated with a high life satisfaction score. Factors associated with a life satisfaction score greater than 6 points were higher social class and educational attainment, adequate income to meet living expenses, satisfactory living arrangement, Christianity, good social support, participation in social activities, functional independence, good self-perceived health, good hearing and vision, daily exercise, absence of recurrent falls, and low depressive symptom score. Multiple logistic regression identified having two or more relatives and tertiary education as positive associated factors, whereas inadequate income to meet expenses, dissatisfaction with living arrangement, nonparticipation in religious group activities, and a high depressive symptom score were negative associated factors. CONCLUSION: In older Chinese, social factors such as the support provided by family members, as well as adequate income to meet living expenses, play a role equal to that of physical factors in contributing to life satisfaction.
Age Factors↗
Age-associated gait changes in the elderly: pathological or physiological?
AIM: To examine the role of disease-related factors and age-related physiological changes in affecting gait speed and stride length in the elderly. SUBJECTS: 925 men and 890 women aged 70 years and above who were ambulant, recruited by random sampling stratified according to age and sex, from all recipients of Old Age and Disability Allowance in Hong Kong. DESIGN: Gait was assessed by measuring the time taken and the number of steps required to complete a 16-foot walk. Information on health and functional status, cognitive function, and depressive symptoms was collected, and anthropometric indices obtained. Factors affecting walking speed and stride were examined in the overall population and also after excluding those with physical disability or diseases. RESULTS: Results were analyzed separately for men and women since mean walking speed was slower in women, who also took a larger number of steps. Age, coexisting disease, leg or back pain, poor vision, low level of physical activity, functional and cognitive impairment, high depressive symptom score, and anthropometric indices were all negatively associated with walking speed. Fallers also had slower speed. After excluding those with diseases or physical impairment, multivariate analysis showed that the only factors affecting speed were age in men, and age, height, and level of physical activity in women. Age and height were factors associated with stride length in men, and height only for women. CONCLUSION: Both disease-related factors as well as age-related physiological changes contribute to the decline in walking speed and stride length.
Age Factors↗
Drug use in an elderly Chinese population: prevalence and associated factors.
This study examined the pattern of drug use in an elderly population aged 70 years and over, and the factors associated with drug use. The study population was selected by stratified random sampling of all registered recipients of Old Age and Disability Allowance in Hong Kong. 997 men and 1,035 women were interviewed as part of a survey on physical, functional, mental health and social status of the elderly in Hong Kong. 71% of the sample took drugs, the prevalence being higher in women. The most common drugs taken were antihypertensives, skin preparations, vitamins and minerals, other cardiovascular drugs, antacids or H2 antagonists, and non-steroidal anti-inflammatory analgesics (all over 10%). Overall, 66% were using medications that were unlabelled. Factors associated with drug use that were examined included socioeconomic factors, educational level, physical health, cognitive function, depressive symptoms, functional ability, life satisfaction, and living arrangements. Multivariate analysis using forward stepwise logistic regression showed that the use of prescription drugs was associated with the presence of chronic disease, poor self-perceived health and being female. Use of > 5 drugs was associated with similar factors: presence of chronic disease, being female, and residence in institutions. The factors for use of non-prescription drugs were different: living in the community, presence of joint pain restricting activities, dissatisfaction with living arrangements, and age. Reducing the number of unlabelled drugs, restricting access to non-prescription drugs, improving access to doctors and patient education all might well be important measures in improving the therapeutic needs of this elderly population.
Age Factors↗
Respiratory symptoms in elderly Chinese living in Hong Kong.
Respiratory diseases can cause considerable disability in the elderly because of their limited respiratory reserve as a result of ageing. We have investigated the prevalence of respiratory symptoms and diseases in elderly Chinese in Hong Kong and compared these data with those in elderly Caucasian populations. Two thousand and thirty two (999 male and 1,033 female) subjects, selected by age-stratified random sampling from a register of Hong Kong residents aged 70 yrs and over were interviewed to complete a respiratory questionnaire. Total serum immunoglobulin E (IgE) was measured in 195 subjects. At least one respiratory symptom was reported by 56% of subjects. The most frequently reported symptoms were morning phlegm (26%), chronic cough with phlegm (10%) and wheeze in the past 12 months (8%). Of the self-reported diseases, the commonest was chronic bronchitis (7%), followed by asthma (5%), pulmonary tuberculosis (3%) and emphysema (2%). Of the 218 subjects with obstructive airway diseases, 128 (59%) had sought medical advice in the past 12 months. The most important determinants for respiratory symptoms and diseases were smoking and social class. Total serum IgE was significantly higher in current smokers than nonsmokers and also in those with chronic cough and phlegm than those without these complaints. Our study shows that respiratory ailments in Hong Kong elderly are as common as those reported in Sweden and the USA but less than those in England.
Aged↗
Drug treatment of hypertension in the elderly: a meta-analysis.
PURPOSE: A meta-analysis of the effect of antihypertensive drug treatment on mortality and morbidity in elderly patients. DATA SOURCES: A literature search of published articles from January 1980 to February 1992. STUDY SELECTION: Randomized controlled trials of drug treatment of hypertension with end points for elderly patients reported separately. DATA EXTRACTION: Mortality or morbidity end points or both in patients older than 59 years were pooled by determination of typical odds ratio. A meta-regression was used to study heterogeneity. RESULTS: Nine major trials with 15,559 patients older than 59 years were identified. Death rates in the control group varied between 2.7% and 77.2%; stroke and coronary mortality increased with the severity-of-illness rank (P < 0.001). Overall, treated patients had an approximately 12% reduction in all-cause mortality (odds ratio, 0.88; 95% CI, 0.80 to 0.97; 953 events compared with 1069 events, P = 0.009). There was a 36% reduction in stroke mortality (odds ratio, 0.64; CI, 0.49 to 0.82; 94 events compared with 149 events, P < 0.001) and a 25% reduction in coronary heart disease mortality (odds ratio, 0.75; CI, 0.64 to 0.88; 263 events compared with 350 events, P < 0.001). Coronary morbidity was reduced 15% (odds ratio, 0.85; CI, 0.73 to 0.99; 325 events compared with 379 events, P = 0.036), and stroke morbidity was reduced 35% (odds ratio, 0.65; CI, 0.55 to 0.76; 247 events compared with 382 events, P < 0.001). CONCLUSION: Overall, treatment of hypertension in elderly patients produces a significant benefit in total mortality and cardiovascular morbidity and mortality. However, this benefit may be reduced in the oldest age groups.
Aged↗
Guidelines for meta-analyses evaluating diagnostic tests.
OBJECTIVES: To introduce guidelines for the conduct, reporting, and critical appraisal of meta-analyses evaluating diagnostic tests and to apply these guidelines to recently published meta-analyses of diagnostic tests. DATA SOURCES: Based on current concepts of how to assess diagnostic tests and conduct meta-analyses. They are applied to all meta-analyses evaluating diagnostic tests published in English-language journals from January 1990 through December 1991, identified through MEDLINE searching and by experts in the field. STUDY SELECTION: Meta-analyses were included if at least two of three independent readers regarded their main purpose as the evaluation of diagnostic tests against a concurrent reference standard. DATA EXTRACTION: By three independent readers on the extent to which meta-analyses fulfilled each guideline, with consensus defined as agreement by at least two readers. DATA SYNTHESIS: The guidelines are concerned with determining the objective of the meta-analysis, identifying the relevant literature and extracting the data, estimating diagnostic accuracy, and identifying the extent to which variability is explained by study design characteristics and characteristics of the patients and diagnostic test. In general, the guidelines were only partially fulfilled. CONCLUSION: Meta-analysis is potentially important in the assessment of diagnostic tests. Those reading meta-analyses evaluating diagnostic tests should critically appraise them; those doing meta-analyses should apply recently developed methods. The conduct and reporting of primary studies on which meta-analyses are based require improvement.
Bias↗
Risk of gastrointestinal bleeding from dexamethasone in children with bacterial meningitis.
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Blood↗
Technician assistance in switching patients from injectable to oral therapy.
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Administration, Oral↗
Double-blind, controlled calcium supplementation and bone mineral accretion in children accustomed to a low-calcium diet.
A randomized, double-blind, controlled calcium supplementation trial was conducted for 18 mo to determine its effects on bone acquisition and height increment in 162 7-y-old Chinese children (87 boys and 75 girls) with habitually low calcium intakes (280 mg/d). Distal one-third radial bone mineral content (BMC), area bone density (BMC/bone width), and height were evaluated every 6 mo. Baseline dietary intakes, serum 25-hydroxycholecalciferol, and physical activity were determined. The study group received 300 mg Ca/d as calcium carbonate; control subjects received placebo tablets. After 18 mo the study group had significantly greater gains in BMC (16.5% vs 13.97%; P = 0.02) and BMC/bone width (9.45% vs 6.31%; P = 0.0008) than the control subjects. The findings confirm a positive effect of calcium intake on bone acquisition but no effect on height increment. Whether a higher bone mass attained at age 8-9 y would be maintained and beneficial to future peak bone mass requires longitudinal investigation. Further study is warranted to determine calcium requirements for Chinese children.
Body Height↗
Comparison of a standard and a sensitive thromboplastin in monitoring low intensity oral anticoagulant therapy.
The greater precision in prothrombin time monitoring obtained using thromboplastins with low international sensitivity index (ISI) values are believed to result in improved patient care. The authors conducted a blinded prospective study of 84 random patients on low-intensity warfarin therapy who were monitored with either a sensitive (ISI, 1.3) or standard (ISI, 1.9) thromboplastin. For the patients monitored with standard and sensitive thromboplastins, respectively, no difference was found in the degree of anticoagulation (standard thromboplastin mean INR, 2.4 vs. 2.5, P = .37; sensitive thromboplastin mean INR, 2.6 vs. 2.6, P = .74; mean daily warfarin dose, 5.1 vs. 4.7 mg, P = .28) or efficacy (warfarin dosage adjustments, 117 vs. 116; clinic visits, 362 vs. 378; percentage of therapeutic INR determinations, 47% vs. 48%). In addition, no difference was found in bleeding prevalence or severity (.22 vs. .27 events per person-year observation). The authors concluded that monitoring anticoagulant therapy in the INR range of 2-3 with a standard thromboplastin may be comparable to monitoring with a more sensitive thromboplastin with respect to efficacy, safety, and degree of anticoagulation achieved.
Administration, Oral↗
T-cell-rich B-cell lymphoma of the spleen.
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Adult↗
The prevalence of depressive symptoms and predisposing factors in an elderly Chinese population.
In a survey of elderly Chinese aged 70 years and over living in Hong Kong selected by stratified random sampling, the prevalence of depression was determined using the 15-item Geriatric Depression Scale using a cut-off point of 8 (sensitivity 96.3% and specificity 87.5% for this population). Subjects with moderate to severe cognitive impairment (CAPE I/O score < or = 7) were excluded. There were 877 men and 734 women. The adjusted overall prevalence for this population was 29.2% for men and 41.1% for women. The prevalence increased with age in men and was higher in women than in men. Univariate analysis identified many factors in the following areas that were associated with depression: socioeconomic characteristics, functional ability, physical health and social support. Stepwise logistic regression identified 16 factors predictive of depression: socioeconomic characteristics, such as borderline living expenses and dissatisfaction with living arrangement; poor social support, such as absence of an informal carer when ill, few relatives to turn to, and infrequent contact with neighbours and friends; functional disability, as indicated by a Barthel Index < 15, urinary incontinence and inability to do housework; and poor physical health--poor self perceived health, poor vision, difficulty with chewing, history of mental illness, frequent hospital admissions and increased level of symptoms such as poor memory, constipation and dizziness. Some of these factors may be amenable to intervention, and such measures may be important in reducing the high prevalence of depression in elderly people.
Aged↗
Benzodiazepines in the treatment of catatonic syndrome.
During a 5-month period, 18 (8%) of 212 patients admitted to a psychiatric unit affiliated to a teaching hospital were found to have a catatonic syndrome associated with various nonorganic mental disorders. Signs and symptoms of motor retardation predominated the clinical presentations. In the course of a prospective, open study, all 18 patients were challenged by a small dose of oral lorazepam or intramuscular diazepam. Catatonic signs and symptoms in 2 patients showed an immediate, complete, and sustained response to the medication. The remaining 16 patients were maintained on 1 of the 2 benzodiazepines for the next 48 h when their motor status was re-evaluated. Significant clinical improvement was detected in all but 2 patients. However, 9 patients needed electroconvulsive treatment to achieve further improvement. Short-term benzodiazepine administration proved to be a safe and effective treatment of the catatonic syndrome.
Adolescent↗
Age and marital status are major factors associated with institutionalisation in elderly Hong Kong Chinese.
STUDY OBJECTIVE: To determine the need for long term institutional care for elderly Chinese living in Hong Kong and factors associated with institutional living. DESIGN: Survey by interviewer administered questionnaire of a stratified random sample of all recipients of old age or disability allowance covering 90% of the population. SETTING: Survey performed in Hong Kong, a city on the south coast of China with an area of 1070 km2 and approximately six million people. PARTICIPANTS: A total of 2032 subjects aged 70 years and over (999 men, 1033 women) participated. MAIN RESULTS: Overall, 16% of the elderly live in institutions. The percentage is higher in women and in the older age group (81% for those aged 80 years and over). After adjusting for age and sex, the following factors were positively associated with institutionalisation: poor cognitive function, measures of functional disability, poor vision, Parkinson's disease, stroke, and past fractures. Multivariate analysis identified age and marital status as associated factors with the highest odds ratio (13.6 and 7.1 respectively), followed by various disability indicators. CONCLUSION: The survey shows that requirements for long term care places are unlikely to be much affected by preventive measures, and would need to increase by about 30% by 2000 to cope with the projected increase in the number of elderly aged 70 years and over. Measures to provide sufficient trained personnel and policy for regulation of standards should be made.
Activities of Daily Living↗
Prevalence of cognitive impairment and associated factors among elderly Hong Kong Chinese aged 70 years and over.
The prevalence of cognitive impairment was determined in a random age- and sex-stratified sample of 2,011 elderly Hong Kong Chinese, aged 70 years and over, consisting of subjects living in the community and in institutions. The Information/Orientation Section of the Clifton Assessment Procedure was used as the screening instrument using a cutoff point of 7. The overall age-adjusted prevalence was 5% for men and 22% for women, and 15% for both sexes combined. Univariate analysis identified the following associated factors in order of magnitude of the odds ratio: age; history of Parkinson's disease; functional disability; female sex; low educational level; low social class; history of stroke, and low monthly income. Other diseases, such as heart disease, hypertension, chronic lung diseases or diabetes, were not associated factors. In multivariate analysis, all the above factors remained significant with the exception of a history of stroke. The prevalence figures are comparable to other Caucasian and Chinese studies, and the associated factors identified suggest that there may be room for prevention.
Aged↗
Musculoskeletal complaints and associated consequences in elderly Chinese aged 70 years and over.
OBJECTIVE: To determine the prevalence and sites of musculoskeletal complaints and some associated health consequences among elderly Chinese. METHODS: A random sample of all subjects aged 70 years and over stratified by age and sex. Information collected by questionnaire at an interview. RESULTS: Nineteen to 41% of subjects complained of pain at various sites restricting activities, with a higher prevalence for women. The most common 4 sites involved in order of frequency were knee, upper back, ankle/foot, and shoulder. Back pain increased with age in men to reach the same frequency as women in the 90+ age group. Between 6 to 10% of men and 9 to 14% of women used nonsteroidal antiinflammatory drugs. Pain limiting activities were associated with a lower Barthel index, use of walking aids, increased frequency of doctor consultations, sleep disturbance, and higher depressive symptom scores. CONCLUSION: Prevention of conditions resulting in musculoskeletal complaints would be important in the promotion of healthy active life expectancy in the elderly.
Age Factors↗
Cardiovascular symptoms, electrocardiographic abnormalities, and associated risk factors in an elderly Chinese population.
The aim of this study was to determine the prevalence of angina and possible infarct (WHO cardiovascular questionnaire) and electrocardiographic abnormalities (Minnesota Coding) in elderly Chinese subjects aged 70+ years living in Hong Kong, and the association with some cardiovascular risk factors. A subsample of 197 subjects (96 men, 101 women) selected according to geographical area from a territory-wide health survey consisting of 2032 elderly subjects selected by an age and sex stratified random sampling method was studied. Overall, 7% of men and 9% of women had symptoms suggestive of angina, while 6% of men and 4% of women had symptoms suggestive of possible infarct. There were fewer symptoms in the 80+ age group. Forty-two percent of men and 35% of women had normal electrocardiograms. The prevalence of probable ischaemic heart disease (using the Whitehall Criteria) was 6% for men and 7% for women, while the figures for possible disease were 23% and 25%, respectively. The percentage with abnormalities increased with age. The prevalence of coronary heart disease defined by the presence of symptoms, a history of known disease plus use of medication, and electrocardiographic abnormalities suggestive of probable disease, was 26% for men and 27% for women. These findings were comparable with studies in elderly Caucasian populations. Only a higher socioeconomic grouping and lower HDL cholesterol were identified as associated risk factors. It is concluded that the prevalence of coronary heart disease in the elderly Chinese population in Hong Kong is at least as high in Caucasian populations, and few modifiable risk factors were identified in the elderly aged 70 years and over.
Aged↗