Journal of the Indian Academy of Geriatrics最新文献

{"title":"Non-compliance in Elderly Hearing-aid Users","authors":"S. Singhal, R. Kapoor","doi":"10.35262/jiag.v15i3.115-121","DOIUrl":"https://doi.org/10.35262/jiag.v15i3.115-121","url":null,"abstract":"Objective (Background): Despite the scientific advancements, acceptance of hearing-aids remains poor in persons with hearing impairment in the elderly age group. The attitudinal issues play a significant role in their decision to use hearing aids or not. The purpose of this study was to understand the reasons for noncompliance and acceptance of hearing-loss and hearing-aids. Methods: In this questionnaire-based survey study, the Punjabi-language speaking elderly persons having hearing-impairment were identified into two groups, current-user and non-user of hearing-aids. A questionnaire prepared in the Punjabi language was administered, which consisted of twenty questions with a five-point rating scale. It yielded scores in five subscales that probed the social and emotional impact of hearing loss, denial, stigma, manual dexterity. The responses of the participants were then analysed. Result : A total of seventy-four questionnaires were completed. Average time of 9.63 minutes to complete one questionnaire. The mean age of respondents was 67.05 years. Of these, 45.95% were current users, and 54.05% were non-users of hearing aids. The subjects in both groups had a sensorineural hearing loss of moderate to a moderately-severe degree. Appropriate statistical analysis was performed. On average, the non-users had higher scores on the emotional impact of hearing loss, denial, and stigma subscales. Conclusions: The factors responsible for non-usage of hearingaids by the persons with hearing-impairment were a stigma associated with the hearing aid usage; denial of hearing loss; and emotional impact of hearing loss. Both, social impact of hearing loss and poor manual dexterity were not limiting factors for non-compliance in hearing-aid users","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122389003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study on Short Physical Performance Battery in Geriatric\u0000Heart Failure: Prediction of adverse events at six months?","authors":"A. Chaturvedi, S. Lehl, Monica Gupta, Sreenivas Reddy","doi":"10.35262/jiag.v15i3.122-128","DOIUrl":"https://doi.org/10.35262/jiag.v15i3.122-128","url":null,"abstract":"Aims: To evaluate the outcomes of heart failure in the elderly (60 years or older) by Short Physical Performance Battery scores at six months of discharge. Methods: One hundred elderly patients with heart failure were evaluated at discharge, at 3 and 6 months after discharge by Short Physical Performance Battery. Results: Of the 100 patients discharged from hospital, mean age was 65.13 ± 6.3 years, 65 percent were males, Heart failure with reduced ejection fraction was present in 77%, and 26 (26%) had died by six months. Readmissions were mainly due to acute decompensated heart failure or Chronic Obstructive Pulmonary Disease exacerbations. There was a good correlation between Short Physical Performance Battery and Ejection fraction. The Short Physical Performance Battery scores were low at discharge but improved over six months in those who were alive. All those who died at six months had a baseline Short Physical Performance Battery score of 6 or less. Conclusion: The Short Physical Performance Battery can identify heart failure patients at discharge who have a high risk of short term mortality. A multi-disciplinary intervention may be useful in improving outcomes.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124287583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with the Outcome of Older Patients Admitted\u0000in Geriatric Intensive Care Unit","authors":"D. Thangam, S. Deepa","doi":"10.35262/JIAG.V15I2.53-58","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.53-58","url":null,"abstract":"Objective: To determine the factors associated with the outcome of older patients admitted in Geriatric Intensive Care Unit. Materials and Methods: This cross-sectional, observational study was conducted in the Geriatric Intensive Care Unit of the Department of Geriatric Medicine, Madras Medical College, Chennai. one\u0000hundred and seventy two patients, aged 60 and above, admitted in the Geriatric ICU during the period of 6 months, from January 2017 to June 2017, were selected to participate in this study. Data regarding age, sex, number of comorbidities, major organ system involved, duration of stay and procedures underwent in the ICU\u0000were collected and analyzed. Results: Out of the 172 samples, 92 were males, and 80 were females. The mean age of the study population was 70.1 ± 8.3 years. We found no association between age and survival (p=0.581), gender and survival (p=0.298). 30.2% of the samples who expired had four comorbidities. We found a statistically significant association between the number of comorbidities and outcome (p<0.008). Around 44\u0000patients (25.6%) had respiratory problems, and it was the commonest cause of admission to ICU in this study. We found no association between major system involved and outcome (p=0.089). Sixty of the study participants (34.9%) needed mechanical ventilatory support. We found a statistical significance between procedure underwent and outcome (p<0.001). 57.5% of the study participants stayed in the GICU up to 1 week. We found a statistical significance between the duration of stay and outcome (p=0.022). In this study, 71.5% of the study participants survived, 3.5% of them went against medical advice, and 25% of them expired.\u0000Conclusion: In this study, the outcome of older patients admitted in Geriatric Intensive Care Unit depended on the number of preexisting comorbidities, length of stay and procedure underwent during the ICU stay but not the chronological age. In this study, only one in four died after undergoing treatment in the Geriatric Intensive care unit. Geriatric intensive care services can improve the outcome of older patients admitted with a critical illness.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127508761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia and its Association with Geriatric Syndromes and\u0000Quality of Life in Older Indian Outpatients –\u0000A Cross-sectional Pilot Observational Study","authors":"Sunny Singhal, G. Dewangan, Rishav Bansal, A. Upadhyay, S. Dwivedi, C. Das, P. Chatterjee, A. Dey, A. Chakrawarty","doi":"10.35262/JIAG.V15I2.66-74","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.66-74","url":null,"abstract":"Background: Despite the huge clinical impact of sarcopenia, there is very little to no data from Indian subcontinent regarding sarcopenia in older adults. We conducted this study to assess the frequency of sarcopenia in Indian older outpatients and its characteristics and associations with various geriatric syndromes and quality of life in Indian older adults. Methods: 100 participants above the age of 65 years were recruited from the outpatient department of Geriatric Medicine of a tertiary care hospital in India. Muscle mass, muscle strength and physical performance was measured by DXA scan (Dual Energy X-ray Absorptiometry), hand-held dynamometer and 4 m gait speed respectively. Sarcopenia was identified using an Asian working group for sarcopenia (AWGS) criteria. Many geriatric syndromes such as osteoporosis, dementia, depression and malnutrition were assessed using DXA scan (Dual Energy X-ray Absorptiometry), HMSE (Hindi Mental State Questionnaire), GDS-5 (Geriatric Depression scale – 5 item questionnaire) and MNA (Mini Nutritional Assessment) respectively. Quality of life was assessed using the OPQOL-brief questionnaire. Results: The preval nce of sarcopenia in our study population was 53% (49.3% in males, 61.3% in females). Hypothyroidism, neurological disease and osteoporosis were the only comorbidities found to be positively associated with sarcopenia. Among geriatric syndromes, nutrition and cognition were negatively associated with sarcopenia. Sarcopeniawas also negatively related to the quality of life. Multivariate stepwise logistic regression analysis showed that osteoporosis (OR: 5.43; 95% CI: 1.57-18.81; p-value: <0.01) was significantly associated with sarcopenia. Conclusion: Sarcopenia was common among Indian older outpatients with increased risk of geriatric syndromes and poor quality of life, therefore, a regular sarcopenia assessment may be considered in elderly patients.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125822096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy in Elderly: Overview, Prevalence and Psychiatric\u0000Perspectives","authors":"Priyam Sharma, P Khuda, N. Gupta","doi":"10.35262/JIAG.V15I2.83-89","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.83-89","url":null,"abstract":"Introduction: Ageing is a natural phenomenon that is accompanied by a cascade of unwanted and unintended circumstances or problems that are always undesirable but not still avoidable. Polypharmacy or irrational use of medicines is one of the many issues that may affect any age group but mostly affects the geriatric population. Since ageing is usually associated with several co-morbities, elderly are exposed to\u0000polypharmacy to greater extent. Lack of knowledge about the outcomes of olypharmacy adds to the suffering of elderly due to adverse drug reactions caused by drug interactions. Aim: The primary objective of the present study is to assess the prevalence of polypharmacy along with its association with psychiatric problems and how they influence polypharmacy. Methods: A literature review of electronic databases utilizing the search terms polypharmacy, polypharmacy in elderly, polypharmacy and ageing, multiple medications, inappropriate medication and prescribing cascade etc. for the period from 2010 to 2018 was done. The search was supplemented with online site searches of relevant medical, health and pharmaceutical journals. Also, literature comprising of original articles, and case studies were studied to identify articles which correspond to various definitions, causes, types of polypharmacy etc. The priority of search was geriatric pharmacy. Thus, the studies or the articles matching the geriatric age group were considered, and adequate data was extracted. A specific protocol regarding the sectioning of search like relevant data & irrelevant data was then incorporated to collect the most suitable and the authentic material for the review. Results: The aged population practice polypharmacy more in comparison to other age groups. Psychiatric illnesses further, enhances the polypharmacy. Conclusion: The findings suggested that polypharmacy is associated with the worsening of the health of the elderly due to its positive association with mental health problems.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"270 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115955236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Safety of Narrowband Ultraviolet B Phototherapy\u0000in Geriatric Patients: A Retrospective Study","authors":"Yusharyahya Sn, L. Legiawati, R. Astriningrum, Chandrakesuma","doi":"10.35262/JIAG.V15I2.59-65","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.59-65","url":null,"abstract":"Background: Skin diseases can be one of the factors affecting the quality of life of the growing elderly population. In treating various dermatoses in the elderly, structural and physiological changes of the skin due to ageing need to be considered. Phototherapy has been proven to be a valuable modality for many skin diseases in adults. However, there is currently no study evaluating the use of phototherapy to treat skin diseases in geriatric population in Indonesia. Objective: To learn the efficacy and safety of narrowband ultraviolet B (NB-UVB) phototherapy in geriatric patients. Methods: A retrospective study using data from medical records of patients aged 60 years and above that received NB-UVB phototherapy in Dermatovenereology Clinic at the Dr Cipto Mangunkusumo National General Hospital in 2014–2018. Results: From 34 included patients, 21 (61.7%) patients had psoriasis, 9 (26.5%) had vitiligo, and 5 (14.7%) patients had other dermatoses. Psoriasis Area Severity Index (PASI) 75% was achieved by 52.4% psoriasis patients with a median of 22 sessions and cumulative dose of 26.6 J/cm2. Initial repigmentation was seen in 100% of vitiligo patients starting from a median of 6 sessions and a cumulative dose of 1.5 J/cm2. The side effect of erythema presented in 10 (47.6%) patients, with an event rate of 1.48% per session. Severe erythema was experienced by one vitiligo patient requiring a delay in phototherapy session. Conclusion: Phototherapy is a safe and effective modality for the geriatric population with various skin diseases, using doses and frequency similar to those of adult patients.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129120552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric Anaesthesia for Centenarians- A Challenging,\u0000Learning Experience!","authors":"U. Hariharan, V. Nagpal, Devang Bharti, Shubhi Singhal Bharti","doi":"10.35262/JIAG.V15I2.75-78","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.75-78","url":null,"abstract":"With improving healthcare facilities, the geriatric population in India is on the rise. Anaesthesia in the geriatric age group poses many challenges to the peri-operative physician because of the decreased functional reserve and various comorbidities associated with advanced age. In addition to that, there is greater risk of post-operative cognitive dysfunction and delirium. Anaesthesia in patients above 100 years is a sub-speciality in itself, with several special considerations. We, hereby present the case of a 102-year-old female patient with severe aortic stenosis posted for left-sided dynamic hip screw fixation on an emergency basis under low dose, unilateral spinal anaesthesia, supplemented with slow and graded epidural anaesthesia.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114525012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairment and Dementia in Geriatric Population:\u0000Role of Clinical Laboratory","authors":"Abhik K Banerjee, G. Das, Rajarshi Sil","doi":"10.35262/JIAG.V15I2.79-82","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.79-82","url":null,"abstract":"Mild cognitive impairment is an intermediate stage between the expected cognitive decline of normal ageing and the more serious decline of dementia. Dementia is typically diagnosed when acquired cognitive impairment has become severe enough to compromise social and/or occupational functioning. The elderly are at much greater risk for cognitive impairment. Unfortunately, most cases of cognitive impairment without\u0000apparent dementia go undetected and thereby untreated in primary care. Clinical diagnosis supported by appropriate use of diagnostic tests and biomarker is essential to improve the quality of life in these patients. In this article, we discussed the role of clinical laboratories in the diagnosis of cognitive impairment and dementia in the geriatric population.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132670173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Solutions for Frailty: Role of Nurses","authors":"Mohanasudnari Sk, A. Padmaja","doi":"10.35262/JIAG.V15I2.90-94","DOIUrl":"https://doi.org/10.35262/JIAG.V15I2.90-94","url":null,"abstract":"Abstract: Frailty refers to a loss of physiologic function that makes a person susceptible to disability from minor stresses. The frailty syndrome is a collection of symptoms primarily due to the aging-related loss and dysfunction of skeletal muscle and bone, that place older adults at increased levels of risk for disability, dependency, falls, injury, \u0000 ospitalization, need for long term care, and mortality. Frailty is thought distinguishable from disability and comorbidity. Frailty always implies multisystem dysfunction. Severity of\u0000frailty range subclinical to a clinical stage to impending death. It is Important to recognize and treat the frailty syndrome before occurrence of any adverse outcomes. Fried's Phenotype screening tool identifies a person as being frail","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132423143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study of Retinal Nerve Fiber Layer Thickness by using Spectral\u0000Domain Optical Coherence Tomography in Older Adults with\u0000Diabetes Mellitus","authors":"D. Sharma, A. Chauhan, Avisha Mathur","doi":"10.35262/jiag.v15i1.17-21","DOIUrl":"https://doi.org/10.35262/jiag.v15i1.17-21","url":null,"abstract":"Introduction: Peripapillary retinal nerve fiber layer (RNFL) thinning occurs in the diabetic patients earlier than the detectable diabetic retinopathy. We conducted this study to evaluate the RNFL thickness and macular thickness in elderly diabetic patients using optical coherence tomography in comparison to healthy controls. Material and methods: One fifty study participants were divided in 3 groups (50 each): normal subjects, patients with diabetes with no detectable diabetic retinopathy (NDR) and patients with diabetic retinopathy (DR) of differing severity. The RNFL thickness and macular thickness was measured using spectral-domain optical coherence tomography (SD OCT). Results: The RNFL thickness around the optic disc differed significantly among all the 3 groups and tended to become thinner as the patient develops DR in elderly subjects. The mean, superior-temporal and upper nasal peripapillary RNFL thickness differed among all the 3 groups. We observed that, mean superior, temporal, inferior and nasal RNFL tended to be thinner as the patient develops DR. Conclusion: The RNFL thickness, macular thickness and ganglion cell complex thinning differed significantly between the healthy group and diabetic group without clinical DR. The RNFL thinning (measured by Spectral-domain OCT) is an early neurodegenerative ocular change in diabetic patients even before onset of diabetic retinopathy.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128062361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}