Journal of the Indian Academy of Geriatrics最新文献

{"title":"Pattern of dermatoses in the elderly population attending the dermatology clinic at a Tertiary Care Center in South-East Rajasthan","authors":"Avinash Sharma, R. Kushwaha, Vartika Kesarwani, S. Jain, D. Yadav, Sonika Sharma","doi":"10.4103/jiag.jiag_7_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_7_22","url":null,"abstract":"Introduction: The skin acts as the first line of defense for the body against external injuries. With aging, the architecture of the skin undergoes intrinsic changes that impair its capacity for repair. In addition, the aging skin is more susceptible to injury by external stimuli, including ultraviolet rays and environmental pollutants. The combination of these factors predisposes the elderly to a variety of dermatological disorders, including xerosis, pruritus, photoaging, eczematous disorders, and tumors. The elderly (>60 years of age) population in India accounted for 8.6% (104 million) in 2011, and the figure has been projected to increase to 19% by the year 2050. It is imperative to identify the pattern of cutaneous disorders in this population as skin care regimens aimed to improve epidermal function have been shown to be effective in the prevention and treatment of some of these aging-associated cutaneous disorders. Objectives: The objective of the study was to identify the pattern of dermatoses among the elderly population attending the dermatology clinic at a tertiary care hospital in South-east Rajasthan. Materials and Methods: We conducted a cross-sectional descriptive study of patients above the age of 60 years who attended the dermatology clinic at a tertiary care hospital in South-east Rajasthan from May 2018 to May 2020. A combination of history, physical examination, and clinical investigations (when appropriate) were used to establish the diagnosis. Results: A total of 210 patients were included in this study. Most patients were between the age group of 60–65 years (40.47%). One hundred and thirty-eight were male (65.71%) and 72 were female (34.28%), with a male to female ratio of 1.9:1. Our study demonstrated that xerosis was one of the most common diagnoses seen in 126 cases (60%), followed by eczematous skin conditions seen in 82 cases (39%). Conclusion: The elderly constitute an important part of the population. Cutaneous disorders in the elderly range from mild disorders such as cherry angiomas to dermatological malignancies. Therefore, it is important to recognize the pattern of dermatosis in this population so that appropriate therapeutic and preventive strategies could be implemented.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125003333","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":"Association of cognitive function, depression, and quality of sleep with statins among oldest-old individuals","authors":"S. Regalla, Gunampalli Anaika, B. Reddy, P. Sharma, E. Ganguly","doi":"10.4103/jiag.jiag_34_21","DOIUrl":"https://doi.org/10.4103/jiag.jiag_34_21","url":null,"abstract":"Background: Oldest-old population is rapidly increasing in all countries, with many prescribed statin therapy. Statins are associated with multiple cardiovascular benefits at various ages. The benefits of statins above the age of 75 are being questioned. The objective of this study was to measure statins use among the oldest-old population, aged 80 years and above, and to study the effect of statins on cognitive function, depression, and quality of sleep. Materials and Methods: This cross-sectional study randomly enrolled 200 community-dwelling individuals aged >80 years. Data were collected upon home visits on sociodemographic, cognitive functions, depression, sleep, chronic diseases, functional limitations, and disabilities. Cognitive function (Mini Mental State Examination), depression (Geriatric Depression Scale), and quality of sleep (Pittsburgh Sleep Quality Index) among individuals using statins versus not using statins were compared. Chi-square test and t-test were done; odds ratios (ORs) with 95% confidence interval (95% CI) were reported. Logistic regression was done to calculate adjusted OR with age, antidepressants, sedatives, antihistaminics, and sleep medicines. P < 0.05 was considered statistically significant. Results: Overall prevalence of statin use in our study population was 12%; 11.3% in women and 13.2% in men. Cognitive functions, depression, and quality of sleep improved among those using statins (P < 0.05): cognitive impairment – OR: 0.38; 95% CI: 0.16–0.91; depression – OR: 0.41; 95% CI: 0.17–1.02, and poor sleep quality – OR: 0.39; 95% CI: 0.16–0.96. On stratification by gender, men showed a significant association of improved cognitive function and quality of sleep with the use of statins, whereas women did not show any significant associations with cognitive function and quality of sleep but showed almost significant association with improvement in depression. Conclusions: The prevalence of the use of statins was low in our population. Statins had positive effects on cognitive functions, quality of sleep, and depression over 80 years of age in our population, although gender difference exists.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114219671","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":"Young Scholar IAG Kota Chapter Award by IAG Society KOT","authors":"","doi":"10.4103/0974-3405.351305","DOIUrl":"https://doi.org/10.4103/0974-3405.351305","url":null,"abstract":"","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"288 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133974853","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":"Need for a deep dive into the timeline of tech world for people diagnosed with dementia and their family caregivers","authors":"Shweta Kapote, S. Pallerla","doi":"10.4103/jiag.jiag_20_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_20_22","url":null,"abstract":"","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132001620","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":"Orthostatic hypotension: An overlooked but clinically decisive entity","authors":"Gunjan Jain, Sunny Singhal, L. Goyal, Ajay Mathur","doi":"10.4103/jiag.jiag_24_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_24_22","url":null,"abstract":"Orthostatic hypotension (OH) is defined as a drop of >20 mm Hg of systolic or >10 mm Hg of diastolic blood pressure (BP) within 3 min of standing from lying position. It is a common geriatric syndrome caused by impaired orthostatic response of BP. Its clinical manifestation can range from dizziness to syncope. It is a common cause of recurrent falls and fracture in older adults. Its etiology ranges from neurological causes such as Parkinson and diabetes to hypovolemia. Drugs, especially cardiovascular drugs are also frequently identified as the cause of OH. The management of OH is primarily nonpharmacological including medication review, dietary, and lifestyle modifications. However, in partially responsive or resistant cases, medications such as fludrocortisone, midodrine, droxidopa, etc., are also used.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124459971","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":"Spectrum of cardiovascular diseases with increasing age and its association with geriatric syndromes","authors":"A. Chakrawarty, Pramod Kumar, Bhrigu Jain, N. Soni, S. Dwivedi, A. Dey, P. Chatterjee","doi":"10.4103/jiag.jiag_11_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_11_22","url":null,"abstract":"Objective: The burden of cardiovascular diseases (CVDs) is highest among the older adults, who are often carriers of various geriatric syndromes. Studies evaluating CVDs among the old adults in the low- and middle-income countries are limited. This study was conducted to assess the frequency of CVDs and their risk factors among the older population and their association with geriatric syndromes. Subjects and Methods: In this cross-sectional study, 200 health-care seeking adults aged ≥75 years were subjected to routine comprehensive geriatric assessment (assessment for functionality, cognition, depression, frailty, and various geriatric syndromes) and a detailed cardiovascular evaluation using electrocardiography, chest X-ray, echocardiogram, HbA1c level, fasting lipid profile, thyroid function test, serum homocysteine level, and serum NT-pro-BNP. Results: The overall frequency of CVDs in this study was 76%. Polypharmacy, multi-morbidity, cognitive impairment, depression, frailty, and impairment of basic and instrumental activities of daily living were present in 50.5%, 91.5%, 6.5%, 10%, 30.5%, 24.5%, and 55% individuals, respectively. CVDs were significantly associated with increased risk of geriatric syndromes (multi-morbidity [odds ratio (OR) 3.61, confidence interval (CI) 1.13 – 11.54, P = 0.030], polypharmacy [OR 5.46, CI 2.23 – 13.34, P = 0.001] and frailty [OR 3.29, CI 1.01 – 10.64, P = 0.047]). Conclusion: The prevalence of CVDs and their risk factors among the older population was high and significantly associated with increased risk of geriatric syndromes. These observations further strengthen the need for routine geriatric assessment and integrated management of geriatric syndromes in older patients with CVDs.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121757982","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 contributing to falls and the effect of a multipronged approach on the incidence of falls in the older person in an outpatient setting in South India","authors":"J. Thomas, S. Viggeswarpu","doi":"10.4103/jiag.jiag_13_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_13_22","url":null,"abstract":"Background: A fall is an important predictor of morbidity and mortality in an older adult. Objectives: The aim of this study was to enumerate the various factors contributing to falls and assess the effect of a multipronged approach on the incidence of falls in older individuals who are at a risk of falls. Methodology: In this prospective interventional trial, we recruited sixty subjects, who presented to the Geriatrics Outpatient department of a tertiary care hospital in South India. Using the Stop elderly accidents, deaths, and injuries protocol, we included subjects who presented with a history of fall in the year preceding the study, those with fear of fall and those who felt unsteady while standing or walking. These subjects were subjected to a detailed assessment and an individualized multipronged interventional program was initiated. The subjects were followed up telephonically after 1 and 3 months to assess compliance and the details of incident fall (if any). Results: At baseline, 48.3% had fallen in the year prior to enrolment, of whom 16.7% were recurrent fallers. Various contributory factors for falls were identified - including older age, polypharmacy, sedatives, and anticholinergic drugs. Following a multipronged intervention, 3.6% and 5.3% of the subjects reported falls after 1 and 3 months, respectively. Subjective improvement was reported by 80% and 78.2% of the subjects at 1 and 3 months' follow-up and the compliance with exercises during the follow-up period was good (73%). Conclusion: Identifying the subjects at risk for falls and implementing a tailored approach contributed to a reduction in the incidence of falls.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124176758","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":"Massive splenomegaly as the presenting feature of multiple myeloma in an elderly man","authors":"Vaibhav Mishra, A. Pandey, Deeksha Goyal, S. Chakrabarti","doi":"10.4103/jiag.jiag_15_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_15_22","url":null,"abstract":"A 70-year-old man presented with generalized weakness, easy fatigability, and early satiety of 2-month duration. On examination, he had severe pallor and massive splenomegaly. Hematological investigations revealed bicytopenia with hypergammaglobulinemia and acute kidney injury. Bone marrow aspiration cytology was suggestive of plasma cell dyscrasia. Monoclonal protein peak (due to heavy chain of IgG type) was found on serum protein electrophoresis, and lambda light chains and IgG heavy chains were elevated on immunofixation. The patient was diagnosed as a case of multiple myeloma and was started on bortezomib–lenalidomide–dexamethasone regimen. After 7 months of chemotherapy, his spleen had regressed, and the patient had become asymptomatic. Presentation with massive splenomegaly is usually a feature of Waldenstrom's macroglobulinemia. However, rarely multiple myeloma may have extramedullary manifestations such as splenomegaly as the primary presenting feature.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129702462","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":"Isolated systolic hypertension in very elderly","authors":"M. Sharda","doi":"10.4103/jiag.jiag_8_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_8_22","url":null,"abstract":"Globally, hypertension is a common problem in the elderly, and its prevalence increases with increasing age. Isolated systolic hypertension (ISH) subset is more common in the very elderly population, and as the population ages, its prevalence will rise more and more. In the past, treatment of hypertension (HT) in the very elderly was controversial and either no treatment or complications of treatment risk overweigh the benefits observed. The inclusion of elders in various clinical trials has demonstrated a better understanding and rational approach toward optimal management of HT. Systolic blood pressure (BP) is more important in predicting adverse cerebrovascular outcomes and decline in renal function in elderly patients with ISH. Early detection, protection of target organs, correction of high BP will develop, promote, and corroborate healthy aging.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114221101","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 scoping review of community-based geriatric assessment and screening tools used in South Asia","authors":"Sucharita Panigraghi, T. Bhoi, S. Pati, J. Kshatri","doi":"10.4103/jiag.jiag_1_22","DOIUrl":"https://doi.org/10.4103/jiag.jiag_1_22","url":null,"abstract":"Background: Home-based comprehensive assessment and integrated care of the older people could be a key to relieve the pressure on the already overburdened health system. This review summarizes evidence on validated community-based geriatric assessment tools in South Asia. Methods: Guided by Arksey and O'Malley's five-stage scoping review framework, a total of 46 studies were included in the scoping review after searching from electronic databases and reference lists using the predefined eligibility criteria. Data were extracted on the main characteristics of included studies, identified instruments, and their psychometric properties of the tools. This review was reported in accordance with preferred reporting items for systematic reviews and meta-analyses-ScR guidelines. Results: Among the 46 included studies, 10 reported on instruments for medical assessment, 12 on tools for psychological conditions, 13 on tools for functional issues, 2 on social well-being, and 9 on tools with multiple domains of health. Most studies included participants from both gender and different social classes. Majority used measurements that were both self-reported or measured by the investigator, whereas only two instruments were designed to be used by clinicians. In the existing geriatric health assessment tools, environmental domain was neglected completely, and not a single tool considered in this review covered all 5 domains which influence regular life of the elderly. Conclusion: There are no validated tools available that can be used for comprehensive geriatric assessment in South Asia. There is a need to develop and validate culturally sensitive tools that can be used for assessing all the geriatric health domains.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121813310","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}