Beziehungen zwischen Aktivit盲ten des t盲glichen Lebens und Glukosestoffwechsel bei geriatrischen Typ-2-Diabetikern

详细信息    查看全文

• 作者：Dr. med. Andreas Zeug (1)
  Joachim Lindner (2)
  Ulrich Julius (3)
  
• 关键词：Typ ; 2 ; Diabetes im Alter ; geriatrische Rehabilitation ; geriatrisches Assessment ; BARTHEL ; Index ; Aktivit盲ten des t盲glichen Lebens ; Hypoglyk盲mie ; Type 2 diabetes in old age ; geriatric rehabilitation ; geriatric assessment ; BARTHEL ; index ; activities of daily life ; hypoglycemia
• 刊名：Zeitschrift f篓鹿r Gerontologie und Geriatrie
• 出版年：2009
• 出版时间：August 2009
• 年：2009
• 卷：42
• 期：4
• 页码：323-327
• 全文大小：416KB
• 参考文献：1. Arbeitsgemeinschaft Geriatrie Bayern e.V. (2007) www.geriatrie-bayern.de
  2. B眉hl A, Z枚fel P (2005) SPSS 12. Einf眉hrung in die moderne Datenanalyse unter Windows. Pearson Studium Verlag, M眉nchen
  3. Cid-Ruzafa J, Damian-Moreno J (1997) Disability evaluation: Barthel麓s Index. Rev Esp Salud Publica 71:127鈥?37 CrossRef
  4. Collin C, Wade DT, Davies S, Horne V (1987) The Barthel ADL Index. A reliability study. Int Disabil Stud 10:61鈥?3
  5. Croxson S (2002) Diabetes in the elderly: problems of care and service provision. Diabet Med 19:66鈥?2 CrossRef
  6. De Haan R, Limburg M, Schuling J, Broeshart J, Jonkers L, van Zuylen P (1993) Clinimetric evaluation of the Barthels Index, a measure of limitations in daily activities. Ned Tijdschr Geneeskd 137:917鈥?21
  7. Dewing J (1992) A critique of the Barthel-Index. Br J Nurs 1:325鈥?29
  8. Engberg A, Bentzen L, Garde B (1995) Rehabilitation after stroke: predictive power of Barthel Index versus a cognitive and a motor test. Acta Neurol Scand 91:28鈥?6
  9. Fisher BM, Heller SR (1999) Mortality, cardiovascular morbidity and possible effects of hypoglycaemia on diabetic complications. In: Frier, B.M.; Fisher, B.M. (Eds.) Hypoglycaemia in clinical diabetes. Wiley Diabetes in Practice Series. J. Wiley & Sons, Chichester, pp 167鈥?86
  10. Granger CV, Albrecht GL, Hamilton BB (1979) Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel Index. Arch Phys Med Rehabil 60:14鈥?7
  11. Granger CV, Dewis LS, Peters NC (1980) Stroke rehabilitation: Analysis of repeated Barthel Index measures. Arch Phys Med Rehabil 61:355鈥?58
  12. Granger CV, Hamilton BB, Gresham GE, Kramer AA (1979) The stroke rehabilitation outcome study: Part II. Relative merits of the total Barthel Index score and a four-item subscore in predicting patient outcomes. Arch Phys Med Rehabil 60:145鈥?54
  13. Hachisuka K, Ogata H, Okhuma H, Tanaka S, Dozono K (1997) Test-retest and inter-method reliability of the self-rating Barthel Index. Clin Rehabil 11:28鈥?5 CrossRef
  14. H盲ring HU, Joost HG, Laube H, Matthaei S, Meissner HP, Panten U, Schernthaner G (2003) Antihyperglyk盲mische Therapie des Diabetes mellitus Typ 2. Diabetes Stoffw 12 Suppl 2:13鈥?1
  15. Hager K, Nennmann U (1997) Rehabilitation of the elderly 鈥?influence of sex, main diagnosis and activities of daily living (ADL) on the elderly patients return to previous living conditions. Arch Gerontol Geriatr 25:131鈥?39 CrossRef
  16. Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD (1998) Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 21:518鈥?24
  17. Henderson JN, Allen KV, Deary IJ, Frier BM (2003) Hypoglycaemia in insulin-treated diabetes: frequency, symptoms and impaired awareness. Diabet Med 20:1016鈥?021 CrossRef
  18. Heuschmann PU, Kolominsky-Rabas PL, Nolte CH, H眉nermund G, Ruf HU, Laumeier I, Meyrer R, Alberti T, Rahmann A, Kurth T, Berger K (2005) The Reliability of the German Version of the Barthel-Index and the Development of a Postal and Telephone Version for the Application on Stroke Patients. Fortschr Neurol Psychiat 73:74鈥?2 CrossRef
  19. Kamper AM, Stoot DJ, Hyland M, Murray HM, Ford I (2005) The PROSPER Study Group. Predictors of functional decline in elderly people with vascular risk factors or disease. Age Ageing 34:450鈥?55 CrossRef
  20. Kullmann L (1987) Evaluation of disability and of results of rehabilitation with the use of the Barthel Index and Russek麓s classification. Int Disabil Stud 9:68鈥?1
  21. Loewen SC, Anderson BA (1988) Reliability of the modified motor assessment scale and the Barthel Index. Phys Ther 68:1077鈥?081
  22. L眉bke N, Grassl A, Kundy M, Meier-Baumgartner HP, Wilk J (2001) Hamburger Einstufungsmanual zum Barthel-Index. Geriatrie Journal 1-2:41鈥?6.
  23. Mahoney FI, Barthel DW (1965) Functional evaluation. The Barthel Index. Maryland Med J 14:61鈥?5
  24. Naurath HJ (1996) Blutzuckerst枚rungen 鈥?Hyperglyk盲mie. In: F眉sgen, I. (Ed) Der 盲ltere Patient. Problemorientierte Diagnostik und Therapie. 2. Auflage, Urban & Schwarzenberg, M眉nchen; Wien; Baltimore, pp 181鈥?87
  25. P枚tzsch O, Sommer B (2003) Bev枚lkerung Deutschlands bis 2050 鈥?Ergebnisse der 10. koordinierten Bev枚lkerungsvorausberechnung, Statistisches Bundesamt 鈥?Pressestelle, Wiesbaden
  26. Ratzmann KP (1991) Eine Analyse von alters- und geschlechtsspezifischer Diabetespr盲valenz sowie Behandlungsart: Die Berlin-Studie. Akt Endokr Stoffw 12:220鈥?23
  27. Scherbaum WA, Kiess W (2004) Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Alter. Diabetes Stoffw 13 Suppl 2:31鈥?6
  28. Shorr RI, Ray WA, Daugherty JR, Griffin MR (1997) Incidence and risk factors for serious hypoglycemia in older persons using insulin or sulfonylureas. Arch Intern Med 157:1681鈥?686 CrossRef
  29. Stone SP, Ali B, Auberleek I, Thomsell A, Young A (1994) The Barthel Index in clinical practice: use on a rehabilitation ward for elderly people. J R Coll Physicians Lond 28:419鈥?23
  30. Sulter G, Steen C, De Keyser J (1999) Use of the Barthel Index and modified Ranking scale in acute stroke trials. Stroke 30:1538鈥?541
  31. Wade DT, Collin C (1988) The Barthel ADL Index: a standard measure of physical disability? Int Disabil Stud 10:64鈥?7
  32. Wei脽, C (2005) Basiswissen Medizinische Statistik, Springer Medizin Verlag, Heidelberg
  33. Wellwood I, Dennis MS, Warlow CP (1995) A comparison of the Barthel Index and the OPCS disability instrument used to measure outcome after acute stroke. Age Ageing 24:54鈥?7 CrossRef
  34. Zijp EM, Van Den Bosch JS, van Hezik S (1995) Geriatric rehabilitation in a nursing home and the Barthel Index as a parameter. Ned Tijdschr Geneeskd 139:1037鈥?041
  
• 作者单位：Dr. med. Andreas Zeug (1)
  Joachim Lindner (2)
  Ulrich Julius (3)
  
  1. Arztpraxis Allgemeinmedizin, Am Sand 14, 09217, Burgst盲dt, Deutschland
  2. Geriatriezentrum Chemnitz /, Bergarbeiterkrankenhaus Schneeberg, Burgst盲dt, Deutschland
  3. Medizinische Klinik und Poliklinik III, Universit盲tsklinikum Dresden, Kolumnentitel: ADL und Glukosestoffwechsel, Burgst盲dt, Deutschland
  

文摘

In higher age, various diseases are more frequently present and occur in combination, with diabetes mellitus representing the comorbidity seen most frequently. Within the framework of a retrospective study, it has been evaluated whether the degree of metabolic compensation has an influence on the activities of daily life in geriatric patients after an acute event and following rehabilitation treatment. For this purpose over a period of 27 months (01/02/2000 鈥?03/31/2002), diabetic patients of a Saxonian geriatric center (n = 644, mean age 77.86 years/SD 7.115, 30.3% males) were examined before, directly after, and 2 鈥?3 years after rehabilitation. Independent of age, rehabilitation resulted in a significant increase in activities of daily living (ADL, Barthel index); however, after 2 鈥?3 years these values decreased again, not depending on age, but they remained significantly above the baseline values (multiple comparison of mean values). The values at the time of dismissal did not depend on metabolic parameters. The result of the rehabilitation treatment checked by means of a questionnaire 2 鈥?3 years after dismissal showed clear advantages for those patients having a near-normal compensation of metabolism. When HbA1c was below 7% at the time-point of the geriatric rehabilitation the Barthel index score in the questionnaire was found to be significantly higher (multiple comparisons of mean values) than in patients with a HbA1c of 7% or higher. With increasing age, the danger of hypoglycemia was seen to be significantly elevated (Fisher鈥檚 exact test).