{"title":"Nutritional status and food environment of the elderly population residing in tea gardens of a block of Darjeeling District, West Bengal, India","authors":"Kunal Sullar, Pallabi Dasgupta, Kaushik Ishore","doi":"10.4103/jiag.jiag_67_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_67_22","url":null,"abstract":"Objectives: In India, poverty, illiteracy, and difficult terrains make the tea garden elderly population more vulnerable to malnutrition. The food environment shows the interface through which consumers interact with their food system. Hence, the present study was done to assess the nutrition status and identify the sociodemographic and food environmental factors affecting the nutritional status of the elderly population residing in tea gardens of Naxalbari block, Darjeeling district, West Bengal, India. Materials and Methods: A community-based cross-sectional study was conducted in all tea gardens of Naxalbari block, Darjeeling, from March 2022 to September 2022, among older people aged 60 years and above selected by simple random sampling. Using the predesigned, pretested questionnaire, the Mini Nutritional Assessment tool for nutritional assessment and the elderly population's perceived food environment was determined based on five points Likert's scale. Perceived food environment clusters were identified using a two-stage cluster analysis. Binary logistic regression was used to determine predictors of nutritional status. Results: Out of the 294 study participants, the majority of 190 (64.6%) of the older people were at the risk of malnutrition, 18 (6.1%) malnourished, and 86 (29.3%) had normal nutritional status. Binary logistics regression showed older people who were illiterate (adjusted odds ratio [AOR] 14.864; 95% confidence interval [CI]; 4.311–51.457) and not working (AOR 3.775; 95% CI; 1.753–8.128) had significantly higher odds of being undernourished. Older people who perceived a favorable food environment (AOR 0.408; 95% CI; 0.214–0.775) had significantly lesser odds of being undernourished. Conclusion: Tea garden older population is at higher risk of malnutrition. Illiteracy, working status, and perceived favorable food environment plays important role in altering the nutritional status of the elderly. Prior interventions such as awareness regarding food nutrition and developing elderly friendly food environment are needed.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117183143","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}
Reena Mohan, E. Kadhiravan, A. Devi, R. Sindhuri, Shiek Abdula, D. K. Devi
{"title":"Anemia in elderly patients ≥65 years of age: a hospital-based cross-sectional study","authors":"Reena Mohan, E. Kadhiravan, A. Devi, R. Sindhuri, Shiek Abdula, D. K. Devi","doi":"10.4103/jiag.jiag_57_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_57_22","url":null,"abstract":"Introduction: Anemia in elderly patients of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life. Despite of high prevalence, very few studies have examined the effect of anemia in elderly patients in India. Hence, this study is undertaken to know the prevalence and clinicopathological pattern of anemia in elderly patients. Objectives: 1. To estimate the prevalence of anemia in the elderly aged 65 years and above. 2. To determine the severity, clinicohematological patterns, and causes of anemia in the elderly aged 65 years and above. Materials and Methods: A hospital-based descriptive cross-sectional study was done. The study was conducted for 1 year; during this period, elderly patients aged 65 years and above admitted for other medical conditions were recruited in the study using consecutive sampling technique until the desired sample size of 236 was achieved and they were evaluated for anemia. Among them with hemoglobin cutoff value <13 g% for men, <12 g% for women were further evaluated to known the cause of anemia and its clinicohematological pattern. Ethical committee approval was obtained. Data were analyzed using SPSS Software version 23.0. Results: The mean age of the participants was 73.9 ± 7.4 (standard deviation [SD]) years. Majority, 53.8%, of the participants were males. Among the 236 elderly patients, recruited in the study 65.3% were anemic and among them 44.2 had mild anemia and 37% had moderate anemia. Mean hemoglobin value of the participants was 10.7 ± 2.83 SD and it ranged from 3 to 16.3 g/dl. There was no significant difference in the hematological parameters between male and female elderly patients in the study. The main cause of anemia was found to be due to chronic diseases followed by iron-deficiency anemia. Conclusion: This study concludes that anemia was highly prevalent among elderly patients and most of them had identifiable and treatable etiology. Hence, all elderly patients with anemia should be evaluated properly for underlying etiology and treated accordingly to reduce the mortality and morbidity in elderly patients with multiple comorbidities.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115274342","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":"Strengths, weaknesses, opportunities, and threats analysis of the national program for health care of the elderly","authors":"N. Joshi, Vibha Joshi, Komal K. Bajaj","doi":"10.4103/jiag.jiag_9_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_9_23","url":null,"abstract":"Background: The National Program for the HealthCare of the Elderly (NPHCE) was adopted by the Ministry of Health and Family Welfare in 2010 to provide promotional, preventive, curative, and rehabilitative health-care services for the fast-growing older population in India. As literature about the assessment of NPHCE is lacking, the present study was conducted to perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the program. Methods: The SWOT of the NPHCE program is analyzed using available literature and relevant documents. Results: Although this program embraces strategies to provide specialized training and services at primary health center, community health center, and district levels, including dedicated bedded wards, equipment, consumables, and pharmaceuticals but home-based care for the elderly, and the role of caregivers is overlooked in this program. NPHCE program can utilize the framework and take support of various ongoing healthy aging initiatives of international agencies to augment the health-care strategies for the elderly in India. Integrating schemes developed by the government for the upliftment of the elderly and the inclusion of traditional medicine systems in the program can serve as an opportunity for meeting unmet needs and improving the quality of life and well-being of the elderly. However, the growing elderly population, rise in nuclear families, and dual disease burden are significant threats to the program's implementation. Conclusion: This program can be more effective in providing comprehensive health care to the elderly if more emphasis is given to community participation, home-based care, and integrating digital health technologies and other existing welfare schemes.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115340456","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":"Repigmentation of gray hair: A case report with a brief review of literature","authors":"Vinod P Jerath, Richa Nischal, A. Jerath","doi":"10.4103/jiag.jiag_17_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_17_22","url":null,"abstract":"A case of gray hair nearly 99% was seen to be converted to more than 99% of the pigmented hair, after using full sleeves shirts for 2 years, with 1-year follow-up, with the same results, and on screening the literature, we find it first such case in the world literature of almost complete repigmentation of both the forearms after using full sleeves shirts for 2 years and a follow-up of 1 year.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125578197","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}
M. Sharda, Ankit Vijay, N. Gandhi, Meghna Aggarwal
{"title":"Factors predicting mortality in elderly patients hospitalized for congestive heart failure","authors":"M. Sharda, Ankit Vijay, N. Gandhi, Meghna Aggarwal","doi":"10.4103/jiag.jiag_21_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_21_22","url":null,"abstract":"Background: Heart failure (HF) is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. There are range of factors that predict the mortality, morbidity, and outcome in congestive HF (CHF) patients. Objectives: The objective was to study the clinico-epidemiological characteristics and predictors of inhospital mortality of elderly patients ≥60 years hospitalized for HF. Subjects and Methods: A complete medical history of enrolled patients and physical examination inclusive of etiology, New York Heart Association (NYHA) grade, heart rate (HR), and systolic blood pressure (SBP) were noted. Complete blood count, blood urea, serum creatinine, serum sodium, serum potassium, 12-lead electrocardiogram, X-ray of the chest, and echo were obtained in all patients. Outcomes were analyzed till the study endpoints. Results: Compared to normal comparators, a higher mortality was observed in patients with age >75 years (33.3%), HR >100 beats per min (27.14%), SBP <80 mmHg (60%), NYHA IV HF (37.1%), hemoglobin (Hb) <12 mg/dl (31.25%), blood urea ≥40 mg/dl (26.39%), serum creatinine >1.30 mg/dl (29.17%), serum sodium <135 meq/L (26.69%), and ejection fraction (EF) <50% (26.39%). Conclusion: Increasing age, prior history of CHF on admission, higher NYHA grade on admission, higher HR, lower SBP, lower EF, low Hb, higher blood urea, serum creatinine, and low serum sodium levels are statistically significant predictors of inhospital mortality of elderly CHF patients.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133426635","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":"Characteristics of centenarian studies and variables related to longevity: A narrative review","authors":"S. Teo","doi":"10.4103/jiag.jiag_15_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_15_23","url":null,"abstract":"Studying centenarians requires a “positive biology” approach, where rather than focusing on disease, the research aims to understand the causes of positive phenotypes and explain biological mechanisms of health and longevity. This review outlines the characteristics of the key centenarian studies. Variables that may relate to the longevity of these oldest old are also described, including cardiovascular health, cognitive function, physical ability, mental and cognitive health, personality, and the social circumstances of the centenarian.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123706849","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}
Pratap Kumar, Minakshi Dhar, B. Kumar, Vikram Jain
{"title":"Frailty as a predictor of outcome in heart failure in the elderly: An observational study at a tertiary care center","authors":"Pratap Kumar, Minakshi Dhar, B. Kumar, Vikram Jain","doi":"10.4103/jiag.jiag_12_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_12_23","url":null,"abstract":"Introduction: Heart failure is the leading contributor to global morbidity and mortality. Frailty is an emerging prognostic factor in heart failure. There is little data on the prognostic role of frailty in patients admitted for acute heart failure as most studies have been done on stable heart failure patients. Methodology: The study included elderly (age ≥60 years) patients admitted with acute heart failure at a tertiary care center in India. Patients with dementia, cognitive impairment, and documented terminal illness were excluded. The sample size was 85 patients. Frailty assessment was done using short performance physical battery (SPPB) and Fried phenotype scales and follow-up data was collected at 3 months postdischarge telephonically. The primary objective of the study was to determine the proportion of frailty in elderly in-hospital heart failure patients. The secondary objectives were to see the agreement between the frailty assessment tools used (SPPB and Fried phenotype). Results: Eighty seven patients were included in the study. The majority were male (n = 45) and had heart failure with reduced ejection fraction (n = 56). Coronary artery disease (CAD) (n = 60) was the most common cause of heart failure. Eighty-two patients had at least one comorbidity. The proportion of frailty as per the SPPB was 43.67%, and as per the Fried phenotype was 68.9%. A total of 4 deaths and 15 re-admissions occurred during the follow-up period of 3 months. The majority belonged to the frail category as per both the frailty scales (P < 0.001 for SPPB, P = 0.087 for Fried phenotype). Fleiss's kappa coefficient for agreement between the scales was 0.373 (SE = 0.106, P < 0.001), which signifies that there was a fair agreement between the two scales. The Spearman Rank correlation coefficient was −0.691 (P < 0.01) between the two scales. Hence, the SPPB score inversely correlated with the Fried phenotype. Conclusion: Frailty is largely prevalent in elderly heart failure patients. It can be used to predict poor outcomes in these patients. Clinicians should identify these high-risk patients at the time of discharge from their facility and consider interventions (tailored rehabilitation programs) to minimize the adverse outcomes.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126364774","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}
K. Manish, P. Madhuchandra, K. Pawankumar, KP Raju
{"title":"Geriatric intertrochanteric fractures – A challenge to manage","authors":"K. Manish, P. Madhuchandra, K. Pawankumar, KP Raju","doi":"10.4103/jiag.jiag_10_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_10_23","url":null,"abstract":"Background: Intertrochanteric fractures are among the frequently seen fractures in the elderly population. Treating these fractures is very challenging considering the fact that the quality of bone is poor and highly osteoporotic. The high failure rates with dynamic hip screw (DHS) especially in unstable fractures lead to the development of intramedullary devices such as proximal femoral nail (PFN) which has got multiple advantages over DHS. Materials and Methods: This prospective study included 30 patients above the age group of 60 years with unstable intertrochanteric fractures conducted in a tertiary institute between February 2021 and June 2022. Results were analyzed clinically and radiologically using the Modified Harris hip score. Results: Patients' age group was 61–85 years with a mean age of 69 years, comprising 63% female and 37% male. The average Harris hip score was 83.76 at 24 weeks' follow-up with 33.33% excellent, 56.66% good, 3.33% fair, and 6.67% poor. Postoperative complications included revision surgery in two patients, superficial infection in one patient, Z effect in one patient, peri-implant fracture in one patient. Conclusion: Treatment with PFN for unstable intertrochanteric fracture has the advantages of closed reduction, less tissue damage, early rehabilitation, and return to work. Osteosynthesis with short PFN resulted in good-to-excellent functional and radiological outcomes.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132166256","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":"Comprehensive Geriatric Assessment (CGA) – workshop by the IAG in APICON 2023","authors":"","doi":"10.4103/0974-3405.371911","DOIUrl":"https://doi.org/10.4103/0974-3405.371911","url":null,"abstract":"","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130883257","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":"Caring for the carers of people living with dementia – Looking after yourself as a carer","authors":"P. Srikanth, G. Reddy","doi":"10.4103/jiag.jiag_64_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_64_22","url":null,"abstract":"","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114552971","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}