Treatment Intensity of Psoriasis Decreases With Age

2021 ◽  
pp. 247553032199551
Author(s):  
Suraj Muddasani ◽  
Alan B. Fleischer

Background: Elderly patients have worse skin related quality of life regardless of psoriasis severity. Despite this, there may be risks to starting systemic immunosuppressant therapy, a mainstay for moderate to severe psoriasis, in elderly patients. Objective: We assessed how age relates to treatment intensity for psoriasis. We defined treatment intensity as a continuous scale with a value of 0 indicating no treatment, 1 indicating topical treatment only, and 2 through 4 indicating progressive degrees of systemic treatment. Methods: We assessed the National Ambulatory Medical Care Survey from 1997 to 2016 to determine if treatment intensity for psoriasis was related to a patient’s age. Results: Between 1997 to 2006, a 1-year increase in age was not associated with a change in treatment intensity score for the younger ( p = .4) and older ( p = .8) age groups. Between 2007 to 2016, a 1-year increase in age was associated with a .01 (95% confidence interval .005, .02) decrease in the treatment intensity score ( p = .003) for patients aged 52 or older. When controlling for sex and race, a 1-year increase in age was associated with a decrease of .01 (.02, .005) in the treatment intensity score ( p = .005). There was no association with those who were younger than 52 ( p = .5). Discussion: Physicians provide less intense treatments for elderly patients with psoriasis. This effect has appeared in the last decade. It remains unknown if physicians are being cautious with more intense treatments in elderly patients or if they are unintentionally undertreating this population.

Author(s):  
Laura Iosif ◽  
Cristina Teodora Preoteasa ◽  
Elena Preoteasa ◽  
Ana Ispas ◽  
Radu Ilinca ◽  
...  

The aim of the study was to assess the oral health related quality of life (OHRQoL) of elderly in care homes, one of Romania’s most vulnerable social categories, to correlate it to sociodemographic, oral health parameters, and prosthodontic status. Therefore, a cross-sectional study was performed on 58 geriatrics divided into 3 age groups, who were clinically examined and answered the oral health impact profile (OHIP-14) questionnaire. Very high rates of complete edentulism in the oldest-old subgroup (bimaxillary in 64.3%; mandibular in 64.3%; maxillary in 85.7%), and alarming frequencies in the other subgroups (middle-old and youngest-old), statistically significant differences between age groups being determined. The OHIP-14 mean score was 14.5. Although not statistically significant, females had higher OHIP-14 scores, also middle-old with single maxillary arch, single mandibular arch, and bimaxillary complete edentulism, whether they wore dentures or not, but especially those without dental prosthetic treatment in the maxilla. A worse OHRQoL was also observed in wearers of bimaxillary complete dentures, in correlation with periodontal disease-related edentulism, in those with tertiary education degree, and those who came from rural areas. There were no statistically significant correlations of OHRQoL with age, total number of edentulous spaces or edentulous spaces with no prosthetic treatment. In conclusion, despite poor oral health and prosthetic status of the institutionalized elderly around Bucharest, the impact on their wellbeing is comparatively moderate.


Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Emília Martins ◽  
Rosina Fernandes ◽  
Francisco Mendes ◽  
Cátia Magalhães ◽  
Patrícia Araújo

BACKGROUND: The health-related quality of life construct (QoL) implies a relationship with eating habits (EA) and physical activity (PA). Sociodemographic and anthropometric variables (gender, age and Body Mass Index - BMI) are highlighted in the definition of healthy lifestyle habits promotion strategies. OBJECTIVE: We aim to characterize and relate PA, EA and QoL in children/youth and explore gender, age and BMI influences. METHODS: It is a non-experimental study, with 337 children/youth, ages between 8 and 17 years (12.61±2.96), mostly from the rural inland of Portugal. In data collection we used a sociodemographic and anthropometric questionnaire, a weekly register table of EA and Kid-Kindl (QoL). Statistical analysis (p <  0.05) were performed in SPSS-IBM 25. RESULTS: Lower BMI was associated with better EA (p <  0.001), PA (p <  0.05) and self-esteem (p <  0.01) and worse scores on family subscale of QoL. Female showed higher fruit intake (p <  0.05). The older has shown better results. PA is positively correlated with QoL (p <  0.01) and EA (p <  0.05). CONCLUSIONS: It is important to explore other relevant social and family dimensions, to promote intervention programs with parents, school and community, as well as healthy practices policies. The intervention in these age groups is critical for a longer-term impact in improving healthy life habits.


2013 ◽  
Vol 7 ◽  
pp. CMC.S10628 ◽  
Author(s):  
Carl J. Pepine

This systematic review assessed the impact of atrial fibrillation (AF) and pharmacotherapy on health-related quality of life (HRQOL) in elderly patients. Highly prevalent in the elderly, AF is associated with morbidity and symptoms affecting HRQOL. A PubMed and EMBASE search (1999-2010) was conducted using the terms atrial fibrillation, elderly, quality of life, Medicare, and Medicaid. In all, 504 articles were identified and 15 were selected (studies examining pharmacotherapy [rate or rhythm control] and HRQOL in AF patients with a mean age > 65 years). Information, including study design, cohort size, and HRQOL instruments utilized, was extracted. Five observational studies, 5 randomized trials comparing rate and rhythm control, 3 randomized trials investigating pharmacologic agents, and 2 trials examining HRQOL, depression, and anxiety were identified. Elderly AF patients had reduced HRQOL versus patients in normal sinus rhythm, particularly in domains related to physical functioning. HRQOL may be particularly affected in older AF patients. Although data do not indicate whether a pharmacologic intervention or single treatment strategy—namely rate versus rhythm control—is better at improving HRQOL, either of these strategies and many pharmacologic interventions may improve HRQOL in elderly AF patients. Based on reviewed data, an algorithm is suggested to optimize HRQOL among elderly patients.


2015 ◽  
Vol 42 (4) ◽  
pp. 352-359 ◽  
Author(s):  
Diba Maria Sebba Tosta de Souza ◽  
Daniela Francescato Veiga ◽  
Ivan Dunshee de Abranches Oliveira Santos ◽  
Luiz Eduardo Felipe Abla ◽  
Yara Juliano ◽  
...  

Author(s):  
Natielly Aleixo Inácio ◽  
Manoel Muniz Neto ◽  
Antônio da Silva Menezes Junior ◽  
Joaquim Ferreira Fernandes ◽  
Vinícius Araújo Barbosa ◽  
...  

Author(s):  
Agneta A Pagels ◽  
Maria Stendahl ◽  
Marie Evans

AbstractBackgroundAlthough patient-reported outcome measures (PROMs) are gaining increased interest in developing health care quality and are a useful tool in person-centered care, their use in routine care is still limited. The aim of this study is to describe the implementation and initial results of PROMs via the Swedish Renal Registry (SRR) on a national level.MethodsAfter testing and piloting the electronic PROM application, nationwide measures were carried out in 2017 for completing the RAND-36 questionnaire online or by paper in a wide range of chronic kidney disease (CKD) patients (Stages 3–5, dialysis and transplantation) through the SRR. Cross-sectional results during the first year were analyzed by descriptive statistics and stratified by treatment modality.ResultsA total of 1378 patients from 26 of 68 renal units (39%) completed the questionnaire. The response rate for all participating hemodialysis units was 38.9%. The CKD patients had an impaired health profile compared with a Swedish general population, especially regarding physical functions and assessed general health (GH). Transplanted patients had the highest scores, whereas patients on dialysis treatment had the lowest scores. The youngest age group assessed their physical function higher and experienced fewer physical limitations and less bodily pain than the other age groups but assessed their GH and vitality (VT) relatively low. The oldest age group demonstrated the lowest health profile but rated their mental health higher than the other age groups. The older the patient, the smaller the difference compared with persons of the same age in the general population.ConclusionsNationwide, routine collection of PROMs is feasible in Sweden. However, greater emphasis is needed on motivating clinical staff to embrace the tool and its possibilities in executing person-centered care. CKD patients demonstrate impaired health-related quality of life, especially regarding limitations related to physical problems, GH and VT/energy/fatigue.


Sign in / Sign up

Export Citation Format

Share Document