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ABSTRACT: Elderly people with dementia are at increased risk of falls and intervention trials to prevent falls have failed to demonstrate clinical effectiveness in this population. This study evaluates the role of urinary incontinence as a fall risk factor in older patients with dementia, with the aim of developing relevant intervention strategies.
Elderly patients with dementia visiting our center were recruited. All subjects underwent a Comprehensive Geriatric Assessment (CGA), and patients were divided into two groups (fall and non-fall) according to their history of falls in the past year. Components of the CGA, including physical function, mental function, depressive symptoms, incontinence, and nutritional status, were evaluated according to fall history.
Overall, 159 patients with dementia (mean age 77.3 ± 9.0 years, 59.1% male) participated. Fifty-four patients (34.0%) had experienced falls in the past year. Among all subjects, 50.3% were diagnosed with mild dementia, 37.7% with moderate dementia, and 12.0% with severe dementia according to an established Clinical Dementia Rating scale. Subjects in the fall group displayed poorer physical function, balance, depressive mood, nutritional status, urinary incontinence, and had an increased prevalence of polypharmacy. However, multivariate analysis revealed urinary incontinence as the only independent risk factor for falls (OR = 4.9 ± 2.2, 95% CI: 2.0-12.0, P < 0.001).
Urinary incontinence is a previously unidentified risk factor for falls among elderly dementia patients. An interventional study with the focus of urinary incontinence could improve the effectiveness of fall prevention among these patients.
Neurourology and Urodynamics 05/2011; 30(7):1286-90. · 2.96 Impact Factor
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ABSTRACT: This article presents the demographic characteristics of a sample of Taiwanese sex offenders, examines the rate of sexual recidivism in Taiwan, and describes which factors distinguish recidivists from non-recidivists. This article assesses the recidivism rate of a sample of 503 male sex offenders incarcerated from 1999 to 2004. The sample is divided into two groups: non-recidivists (88.7%) and recidivists (11.3%). The variables are categorized into demographic characteristics, criminal history, interpersonal relationships, and offending behaviors. Multivariate logistic regression analysis suggests that recidivism is significantly related to male victims, poor interactions with employers, verbal control (i.e., threats to or verbal control of victims), weapon control (threatening or controlling victims with weapons), and familiarity with victims. Furthermore, this article will establish a database for demographic characteristics and associated risk factors related to recidivism in incarcerated sex offenders in Taiwan. These data will be useful for preventing future sex crimes.
International Journal of Law and Psychiatry 04/2010; 33(3):144-8. · 1.19 Impact Factor
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Yu-Kuei Chen,
Chien-Hung Lee,
I-Chen Wu,
Jia-Sin Liu,
Deng-Chyang Wu,
Jang-Ming Lee,
Yih-Gang Goan,
Shah-Hwa Chou,
Chia-Tsuan Huang, Chun-Ying Lee,
Hsin-Chia Hung,
Jeng-Fu Yang,
Ming-Tsang Wu
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ABSTRACT: The main objective of this study was to further elucidate the effect of consuming various foods on the development of squamous cell carcinoma (SCC) in three different sections of the esophagus.
A total of 343 patients with SCC of the esophagus and 755 cancer-free control subjects were recruited for this study from 1996 to 2005.
We found that intake of vegetables, raw onions/garlic, and fruits are significantly protective against esophageal SSC risk, whereas intake of hot foods can significantly increase its risk. There was a significant inverse relation between the frequency of tea consumption and esophageal SCC risk (P for trend = 0.005), with a 0.5-fold lower risk associated with the intake of unfermented tea (green tea, oolong tea, or jasmine tea). The effects of dietary factors on esophageal SCC were similar in all subsites, with the exception of consumption of coffee. Coffee consumption was more pronounced in having a protective effect in the middle third section compared with the lower third section of the esophagus (adjusted odds ratio 0.4, 95% confidence interval 0.2-0.9), although this protective effect was marginally significant (adjusted odds ratio 0.6, 95% confidence interval 0.4-1.0) against esophageal SCC in all subsites. Our data also suggest that discomfort when eating hot foods may exert a carcinogenic effect by direct contact with the esophageal mucosa and tend to have more harmful effects in the upper than in the lower esophagus. In contrast, vegetables, fruits, and tea with components that are thought to inhibit carcinogenesis by absorbed components affected all subsites similarly.
Our results add additional information that certain dietary components may affect carcinogenesis locally and systemically.
Nutrition 05/2009; 25(7-8):753-61. · 3.03 Impact Factor
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ABSTRACT: Obesity is a well known risk factor for insulin resistance and type 2 diabetes. Recently discovered adipocyte-derived proteins (leptin and adiponectin) might contribute to the pathologic mechanism linking obesity and insulin resistance. A total of 190 non-diabetic women were recruited from the Obesity Clinic of Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, between February 2003 and February 2004. All participants completed a simple questionnaire. Blood pressure and body mass index were measured; blood samples for fasting glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride, leptin, adiponectin, and fasting insulin level were collected after an overnight fast. Two-hour glucose level after a 75-g glucose tolerance test was determined. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as the index of insulin resistance. Multivariate linear regression analyses were used to analyze the relationship between adipocytokines and insulin resistance after adjusting for possible confounding factors. Leptin and adiponectin were found to be independently associated with HOMA-IR and fasting insulin concentration, but in divergent directions, after adjusting for potential confounding factors. Adiponectin, but not leptin, was associated with impaired glucose tolerance after adjusting for potential confounding factors. The results suggest that leptin and adiponectin may be involved in the pathophysiologic link between obesity and insulin resistance independently. Low levels of adiponectin may increase the risks of developing impaired glucose metabolism and type 2 diabetes.
The Kaohsiung journal of medical sciences 04/2009; 25(3):116-25. · 0.61 Impact Factor
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Chien-Hung Lee,
Jang-Ming Lee,
Deng-Chyang Wu,
Yih-Gang Goan,
Shah-Hwa Chou,
I-Chen Wu,
Ein-Long Kao,
Te-Fu Chan,
Meng-Chuan Huang,
Pei-Shih Chen, Chun-Ying Lee,
Chia-Tsuan Huang,
Hsiao-Ling Huang,
Chih-Yang Hu,
Yu-Hsiu Hung,
Ming-Tsang Wu
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ABSTRACT: The consumption of alcohol, tobacco and betel quid has been found to be an important contributor to esophageal squamous cell carcinoma (ESCC) in Taiwan. The genotoxic effect of the ADH1B and ALDH2 genes modulating an individual's alcohol-metabolizing capacity on ESCC may be linked to drinking behavior, intake pattern and other exogenous factors. To investigate the interplay of these genetic and environmental factors in determining the risk of ESCC, a multicenter case-control study was conducted. Here, 406 patients with pathology-proven ESCC, as well as 656 gender, age and study hospital matched controls were recruited. Genetic polymorphisms of ADH1B and ALDH2 appeared to correlate with the abstinence of alcohol, though not with tobacco and betel quid. Within the same levels of alcohol consumption, carcinoma risks increased along with an increase in the numbers of ADH1B*1 and ALDH2*2 alleles. The inactive ALDH2*1/*2 genotype was found to multiplicatively interact with a low-to-moderate (0.1–30 g/day) and a heavy (>30 g/day) ethanol intake to increase the ESCC risk (the joint aOR = 14.5 and 102.6, respectively). Among low-to-moderate drinkers, a smoking-dependent carcinogenetic effect for the ADH1B*1/*1 and ALDH2*1/*2+*2/*2 genotypes was recognized, with significant risks found in smokers, but not in nonsmokers. Further, a supra-multiplicative combined risk of ESCC for alcohol and tobacco use was identified among carriers of the ADH1B*1/*1 genotype (p for interaction = 0.042). In conclusion, the interplay of the ADH1B and ALDH2 genotypes, in conjunction with a behaved drinking habit and a practiced drinking pattern, along with continued tobacco consumption, plays an important pathogenic role in modulating ESCC risk. © 2007 Wiley-Liss, Inc.
International Journal of Cancer 11/2007; 122(6):1347 - 1356. · 5.44 Impact Factor
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Chien-Hung Lee,
Deng-Chyang Wu,
Jang-Ming Lee,
I-Chen Wu,
Yih-Gang Goan,
Ein-Long Kao,
Hsiao-Ling Huang,
Te-Fu Chan,
Shah-Hwa Chou,
Yi-Pin Chou, Chun-Ying Lee,
Pei-Shih Chen,
Chi-Kung Ho,
Jiang He,
Ming-Tsang Wu
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ABSTRACT: Consumption of alcohol and tobacco, separately or jointly, can increase the risk of oesophageal squamous cell carcinoma (OSCC). It is unclear whether the amount of alcohol consumption by individual drinkers affects the joint carcinogenetic action of both agents. To demonstrate how the intensity of alcohol intake determines the risk of OSCC in relation to tobacco smoking, we conducted a multicentre case-control study. A total of 652 patients with pathology-proven OSCC, as well as 1127 gender, age, and study hospital matched controls were recruited. To identify a possible curvature in the continuous relationship between exposure and risk, we applied the generalised additive models to the collected data. Both non-drinkers who smoked tobacco and non-smokers who drank heavy alcohol (>30 g/day) were observed to have elevated cancer risks. A smoking habit-specific, non-linear increase in oesophageal cancer risk was recognised. Tobacco was found to interact with light-to-moderate alcohol (0.1-30 g/day) to increase the risk of oesophageal cancer in a supra-multiplicative way (Odds ratio (OR) ratio=5.5-5.7, p<0.05), whereas with heavy alcohol consumption in a simple multiplicative model (OR ratio=1.7-2.3, p>0.05). Weekly intake frequency had the strongest influence on the risk of neoplasm development. Alcohol consumption was responsible, respectively, for 18% and 77% of nonsmoking and smoking OSCC cases in this population. In conclusion, both light-to-moderate and heavy alcohol intake interact separately with tobacco in differently synergistic processes that can determine the development of this type of cancer.
European Journal of Cancer 05/2007; 43(7):1188-99. · 5.54 Impact Factor
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Hsiu-Chao Chen,
Frank Huang-Chih Chou,
Ming-Chao Chen,
Shu-Fang Su,
Shing-Yaw Wang,
Wen-Wei Feng,
Pei-Chun Chen,
Juin-Yang Lai,
Shin-Shin Chao,
Shiow-Lan Yang,
Tung-Chieh Tsai,
Kuan-Yi Tsai,
Kung-Shih Lin, Chun-Ying Lee,
Hung-Chi Wu
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ABSTRACT: The enormous job stress of police work may result in depression, which is highly correlated with work disability and poor quality of life. We investigated the quality of life, the probability of depression, and the related risk factors for police officers in Kaohsiung, Taiwan.
We used the 12-item Short-Form Health Survey (SF-12) and the Disaster-Related Psychological Screening Test (DRPST) to assess the quality of life and prevalence of depression for 832 police officers in Kaohsiung.
The estimated rate of probable major depression was 21.6% (180/832). Those with an educational level of university or above and nondepressed police officers had higher scores in every subscale for quality of life. Police officers older than 50 had higher scores in the mental aspects of quality of life. Family problems and job stress related to achievement, peer pressure about performance, and heavy workloads were predictive factors for depression.
Police officers might have a higher estimated rate of depression than previously thought, and those with depression have a poorer quality of life.
Quality of Life Research 07/2006; 15(5):925-32. · 2.30 Impact Factor
