Journal of the Indian Academy of Geriatrics最新文献

{"title":"Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country","authors":"R. Kandel, Joyita Banerjee, M. Saravanan, P. Chatterjee, A. Chakrawarty, S. Dwivedi, B. Mohanti, A. Dey","doi":"10.4103/jiag.jiag_3_21","DOIUrl":"https://doi.org/10.4103/jiag.jiag_3_21","url":null,"abstract":"Introduction: Cancer is a malady of old age. Older people lose autonomy and independence due to age-associated functional decline and adverse consequences of comorbidity. The impact of these variables has an effect on treatment decisions in older cancer patients. Methods: In an observational study, 290 cancer patients aged 60 years or more were evaluated before the initiation of the treatment. They were subjected to a geriatric assessment by various validated assessment tools. Management decisions were as per the prevailing hospital practice. Results: The median age at the diagnosis was 65 years and two-third were males. Lung cancer was the most common (49.3%) diagnosis. The major comorbidities seen were hypertension (34.14%), diabetes (20.34%), and COPD (15%). Depression (57%), cognitive impairment (37%), malnourishment (34%), and vision problem (20%) were common age-related issues observed. Seventy-one percent were dependent in one or more domains of activities of daily living. Eighty-one percent had Eastern Cooperative Oncology Group status score between 0 and 2 (thereby eligible for treatment). In multivariable analysis, good functional status (P < 0.001) and performance status by Karnofsky's Performance Status Scale (P < 0.001) were associated with receiving treatment. Conclusion: Improvement in pretreatment functional status by initial geriatric assessment and requisite interventions may improve the access to and consideration of older cancer patients for standard treatment and care in oncology clinics.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117004058","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":"Statin-induced toxic rhabdomyolysis with hepatocellular jaundice in the elderly","authors":"C. Johnson, Karthik Gunasekaran, Mohan Jambugulam, R. Iyadurai","doi":"10.4103/jiag.jiag_4_21","DOIUrl":"https://doi.org/10.4103/jiag.jiag_4_21","url":null,"abstract":"Adverse drug reactions (ADRs) are a common cause of hospitalization, increased morbidity and mortality in the elderly. ADRs are difficult to diagnose in the elderly as they often present with nonspecific symptoms such as fatigue, falls, cognitive decline, and constipation. Statins are generally well-tolerated drugs used in the secondary prevention of coronary artery disease. We report a 75-year-old lady who developed jaundice and became bedbound due to statin-induced hepatitis and acute rhabdomyolysis causing proximal myopathy following initiation of atorvastatin 40 mg for the management of coronary artery disease. She had rapid clinical improvement with discontinuation of statin therapy and supportive management. ADR must be considered a part of differential diagnosis in elderly patients during the evaluation of illnesses. In the elderly initiated on statins, it is essential to differentiate benign muscle pain from severe muscle injury with biochemical abnormalities. Prompt discontinuation of statins will lead to rapid improvement and prevent further worsening.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116951966","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":"Clinicoepidemiological profile of COVID-19 in elderly patients of South-Eastern Rajasthan","authors":"M. Sharda, P. Jain, Sachin Shyoran, Bhimsain Goyal","doi":"10.4103/jiag.jiag_10_21","DOIUrl":"https://doi.org/10.4103/jiag.jiag_10_21","url":null,"abstract":"Background and Objectives: COVID-19 pandemic took a significant toll on all, especially elderly individuals, who seem to have a higher risk for severe disease and mortality. We aim to study the clinicoepidemiological profile of COVID-19 in elderly patients of South-Eastern Rajasthan and to assess its severity and outcome. Methods: A retrospective analysis of 200 reverse transcription-polymerase chain reaction confirmed COVID-19 patients aged ≥60 years admitted between May and October 2020 in the dedicated COVID hospital of a tertiary care center of South-Eastern Rajasthan was done. Results: The median age of patients was 66 years (interquartile range [IQR]: 63–72 years). Twenty-five percent, 26.5%, and 48.5% cases fell under mild, moderate, and severe disease, respectively, with 52 nonsurvivors. The mean age of severe (68.78 ± 7.20 years) cases was significantly more than that of mild ones (65.96 ± 5.29 years, P = 0.048). Males (70.5%) and urban population (90%) were more affected than females (29.5%) and the rural ones (10%). 67.5% patients had comorbidities. The presence of multiple comorbidities was significantly associated with increased severity (P = 0.03). The median duration of symptoms was 4 days (IQR: 3–7 days). 19% presented asymptomatically. Complications included acute respiratory distress syndrome (47%), renal impairment (31%), hepatic dysfunction (30%), myocardial injury (30%), shock (10.5%), stroke (2%), encephalopathy (2%), acute STEMI (1.5%), deep vein thrombosis (1%), and heart failure (1%). The presence of dyspnea (P = 0.000), desaturation (P = 0.000), leukocytosis (P = 0.000), neutrophilia (P = 0.000), lymphopenia (P = 0.000), high neutrophil-to-lymphocyte ratio (P = 0.000), hyperglycemia (P = 0.015), renal impairment (P = 0.024), elevated creatine kinase-MB (P = 0.020), raised transaminases (P = 0.002), hypoproteinemia (P = 0.003), hypoalbuminemia (P = 0.000), A:G ratio reversal (P = 0.000), low high-density lipoprotein cholesterol (P = 0.000), and higher computed tomography severity score (P = 0.000), all were associated with both increased severity and mortality. Need of vasopressor support was significantly associated with older age (P = 0.022). Conclusion: Increasing age, multiple comorbidities, severe category, and complications are associated with poor prognosis in elderly patients.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121636606","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":"Do medical interns have adequate training in geriatric medicine? A study on the knowledge and attitudes of interns toward older patients at a medical college in Kerala, South India","authors":"Steve Manjaly, Anu Francis, Aaron David Kotturan","doi":"10.4103/JIAG.JIAG_4_20","DOIUrl":"https://doi.org/10.4103/JIAG.JIAG_4_20","url":null,"abstract":"Introduction: With the exponential increase in India's elderly population, the medical students of today need to be well prepared for the demographic changes of tomorrow. Training and attitude of future physicians in elderly care should develop concurrently with the rise in qualifying medical graduates. Objectives: The aim of this study is to determine the knowledge and attitudes of medical students entering internships, toward older people at a teaching hospital in Thrissur, Kerala. Methodology: Medical students of a medical college in Kerala, who were to enter the residency program were enrolled in the study. Sixty-nine students, who voluntarily participated, were asked to complete two questionnaires, the Revised Facts on Aging Quiz, a 25-item multiple-choice test on aging, and the University of California at Los Angeles (UCLA) Geriatric Attitudes Scale, a 14-item questionnaire consisting of a mixture of positively and negatively worded questions answered on a five-point Likert scale. The data obtained were assessed using SPSS version 21. Results: The results indicate that although the medical students entering residency showed a moderately positive attitude (UCLA score 49.67 ± 5.02) toward older people, almost one-third (n = 20, 29%) of these 69 students had poor knowledge (25%–50% score), and the rest (n = 49, 71%) had minimal knowledge (51%–75% scores) on aging. Conclusion: These findings suggest that training in geriatrics is inadequate for MBBS students. More geriatric based content needs to be incorporated into the undergraduate curriculum to address the changing population demographics.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126998151","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":"Situation Analysis Report of Training and Education in South East Asian Countries in Gerontology and Geriatric Medicine","authors":"A. Goel, K. Bansal","doi":"10.35262/jiag.v16i1.22-26","DOIUrl":"https://doi.org/10.35262/jiag.v16i1.22-26","url":null,"abstract":"A population is classified as ageing when older people become proportionately larger share of the total population. Decreasing fertility rates over the last few decades and increasing survival have led to population ageing. A recent report by the United Nations Population Fund released recently indicates that 80% of the world’s older people will be living in the developing world by 2050 and those over 60 will outnumber the under-15 age group by that year.(2) In this background, geriatric medicine and gerontology must be brought into the focus of medical education. This is a trend accepted globally, and geriatricians are the single most numerous internal medicine specialists.(3) However, the change remains limited in developing countries, especially in the South-East Asian Region. The total dependency ratios of the developed and developing nations are comparable. Still, the elderly dependency ratio in the developed countries (>20) is much higher than that of the South-East Asian population (<10). Geriatrics is a specialty that provides expanded expertise in the ageing process, the impact of ageing on illness, drug therapy, health maintenance and rehabilitation.(3) The model of care focuses on working closely with other disciplines including nurses, pharmacists, therapists and social workers.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"778 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122301697","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":"Prevalence and Identification of Elder Abuse in India: Current Scenario and Way Forward","authors":"A. Vidushi, A. Swadia, S. Pruthi, A. Goel","doi":"10.35262/jiag.v16i1.32-37","DOIUrl":"https://doi.org/10.35262/jiag.v16i1.32-37","url":null,"abstract":"Elder Abuse is not only a violation of fundamental human rights but also responsible for significant problems such as injuries, illness, lost productivity, isolation and mortality.(1) Amongst numerous challenges faced by elders, abuse is not only a standard but also a neglected issue. With the population of older people projected to increase to 1.3 billion by 2040, accounting for 14% of the total global population, the problems faced by them warrant priority attention. At present the global rates of Elder abuse range from 3.2%-27.5%.(2)","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132793064","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":"Chronic Diarrhoea associated with Sacubitril-Valsartan use in an Elderly Female - The Benefits of Unprescribing","authors":"S. Chakrabarti, V. Dixit, A. Singh, U. Kaur","doi":"10.35262/jiag.v16i1.38-41","DOIUrl":"https://doi.org/10.35262/jiag.v16i1.38-41","url":null,"abstract":"Sacubitril/Valsartan is a novel Angiotensin Receptor Blocker-Neprilysin Inhibitor (ARNI) approved for the treatment of patients with NYHA class II-IV Heart failure with reduced ejection fraction (HFrEF). Hypotension, renal dysfunction, upper respiratory tract infections and angioedema are the common adverse effects reported with sacubitril/valsartan. Here, we report the first case of chronic non-resolving diarrhoea refractory to conventional therapy in an elderly female on sacubitril-valsartan treatment, which posed a\u0000diagnostic challenge. The case highlights the importance of suspecting novel drugs being sparsely used in the elderly population as the aetiology of new symptoms, and conducting a therapeutic de-challenge even in the face of apparently low causality scores.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130839336","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":"Nutrition in Elderly with Chronic Kidney Disease","authors":"M. Chaturvedy","doi":"10.35262/jiag.v15i3.129-137","DOIUrl":"https://doi.org/10.35262/jiag.v15i3.129-137","url":null,"abstract":"","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"54 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":"129554818","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":"Contributory Factors for Obesity in Elderly: Review of the\u0000Literature","authors":"N. Ismail, N. A. Hamid","doi":"10.35262/jiag.v15i3.138-145","DOIUrl":"https://doi.org/10.35262/jiag.v15i3.138-145","url":null,"abstract":"Introduction: The prevalence of obesity has been rising, adding to morbidity and mortality. As the proportion of elderly aged 60 years and above grows, so too the prevalence of obesity among this population. Obesity in the elderly is a rapidly growing public health concern as it contributes to significant changes in the health of older people. Objective: This review aims to assess the contributory factors for obesity in the elderly over the past decade. Methods: A literature search was conducted. The search was restricted to articles written in the English language published from 2008 to 2018. Qualitative studies were excluded. Results: A total of 19 full articles were retrieved, of which 18 cross-sectional and one cohort were included. The contributory factors were divided into three components: (a) socio demographic characteristics, (b) medical history and dietary factors and (c) environmental factors. Conclusions: This review informs an emerging knowledge regarding contributory factors for obesity and has implications for future education and program\u0000intervention in fighting obesity in the elderly.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"28 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":"128363307","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":"Prevalence of Anemia and its Correlates among Elderly population\u0000of an Urban Slum in Meerut","authors":"R. Lamba, A. Agarwal, Ravi Rana, Vertika Agarwal","doi":"10.35262/jiag.v15i3.109-114","DOIUrl":"https://doi.org/10.35262/jiag.v15i3.109-114","url":null,"abstract":"Background: Anaemia is a major public health problem in elderly persons which is often overlooked. With rising urbanization and world is facing demographic transition, there is a need to increase focus on elderly residing in urban slums. Aim: The present study aims to find the prevalence of anaemia and its associated factors among the elderly population in an urban slum of Meerut. Methodology: The present study conducted\u0000in an urban slum of Meerut from November 2017 to January 2018. The sample size was calculated as 396, considering the prevalence of anaemia as 45.5% in this age group. Haemoglobin levels were estimated using paper chromatography methodby hemoc-heck rapid diagnostic kit. Data were compiled and analysed using epi info software version 3.7.2. Results: 49.5% of the elderly residing in urban slums were found to be anaemic.\u0000The anaemia in the elderly was found to be significantly associated with employment, socioeconomic status and chronic diseases like COPD, hypertension and Tuberculosis","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"101 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":"116935826","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}