Elderly patients with cognitive impairments on an ambulance care

2021 ◽  
Vol 25 (2) ◽  
pp. 19-27
Author(s):  
Tatiana Andreevna Bogdanova ◽  
Anna V. Turusheva ◽  
Elena V. Frolova ◽  
Dmitriy L. Logunov
Keyword(s):  
Cognitive Impairment ◽  
Memory Impairment ◽  
Complete Blood Count ◽  
Beta Blockers ◽  
Blood Pressure Measurement ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Cross Sectional ◽  
Global Cognition

BACKGROUND: Cognitive impairment is one of the most common geriatric syndromes that occur in the elderly. Dementia is a severe cognitive disorder that results in the professional, social, and functional impairment and gradual loss of independence. However, in most cases, the stage of dementia is preceded by a long period of non-dementia cognitive impairment. In this regard, one of the priorities of public health is to identify potentially reversible forms of dementia and cognitive impairment in the early stages. AIM: To assess demographic characteristics, co-morbidities and factors that are associated with cognitive impairment in adults aged 65 years and over and to determine the prevalence of cognitive disorders in aging population. MATERIALS AND METHODS: cross-sectional study included all patients aged 65 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 in Saint Petersburg. Measurements: the Montreal cognitive assessment test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, blood pressure measurement, a medication review and blood tests (complete blood count, lipids, hormones, glucose, ALT, AST and creatinine). RESULTS: The prevalence of mild cognitive impairment was 62.9 % (95 % CI 56-70), severe cognitive impairment 8.2 %. We detected that hypertension, stroke, sleep disorders, subjective memory complaints and symptoms of depression were identified as factors associated with CI after adjustment for covariates. Hypertension and depression were related with cognitive impairment (p 0.05). Also patients with depression scored worse in global cognition and attention function (p 0.05). Patients with diabetes had association with a decrease in abstraction function (p = 0.02). Low hemoglobin levels were related with poor global cognition and memory impairment (p 0.01). Beta-blocker use was significantly associated with poor global cognition and memory impairment (p 0.01). CONCLUSIONS: We found that elders have a high prevalence of cognitive disorders. We also demonstrated association between co-morbidities and factors as hypertension, anemia, diabetes, depression and administration of beta-blockers with poor cognitive performance in the elderly.

scholarly journals Awareness of Medical Workers with Early Diagnosis of Cognitive Disorders at the Primary Health Care Level in the Republic of Kazakhstan

2020 ◽  
Vol 8 (E) ◽  
pp. 595-600
Author(s):  
Assel Tukinova ◽  
Gulnar M. Shalgumbayeva ◽  
Zhanna A. Mussabekova ◽  
Roza A. Abzalova
Keyword(s):  
Cognitive Impairment ◽  
Early Detection ◽  
Early Diagnosis ◽  
Work Experience ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Region Of Residence ◽  
The Republic

   BACKGROUND: Early detection of cognitive impairments (CIs) has been identified as one of the most important factors for the treatment of the disease. The World Alzheimer report 2011 states that the earlier a diagnosis is known, the better patients can be treated medically, patients and their family members can adapt to the development and learn to deal with the disease. Early diagnosis also leads to higher cost-effectivity, which will further improve, when treatments and social care interventions become more effective in future. It is the first-contact doctor who becomes the main figure in identifying the patient’s cognitive disorders. AIM: This study aimed to research the awareness of medical workers with early diagnosis of cognitive disorders at the PHC level in Kazakhstan. METHODS: It was a cross-sectional study. A survey of primary healthcare workers was conducted to study the early diagnosis of CI in the elderly in the period from December 2019 to March 2020. The questionnaire was developed independently according to international finding and experiences and passed the validation process. The questionnaire included questions such as age, gender, nationality, education, specialty, work experience, conduct early diagnosis of CI or not, what methods respondents know, time available for admission for early diagnosis, desire to learn early diagnosis methods, and the region of residence. RESULTS: The total number of respondents was 823. To the question, “Do you check older patients for early cognitive impairment?” 335 (40.7%) answered “no.” To the question “Do you have time to use methods for the early diagnosis of cognitive impairment in the elderly during admission?” “no” – 354 (43%). To the question “Would you like to learn methods for the early diagnosis of cognitive impairment in the elderly?” The answer was “yes” 759 (92.2%) of respondents. This study reveals that the presence of time during admission, the region of residence, and the desire to study affect whether elder people check for early CI or not, in turn, specialty, education, gender, nationality, age, and work experience do not affect. We have identified a relationship of age, region of residence with the availability of time during admission to use methods for early diagnosis of CI, while it was absent with work experience. The region of residence, the availability of time during admission, and education influenced the respondents’ desire to learn early diagnosis methods, while age and work experience did not. CONCLUSION: The problem of early diagnosis of CI in the elderly at the PHC level is relevant and not fully understood. Early detection of CI at the PHC level is a key element in the fight against such a serious condition as dementia.

scholarly journals Physical activity and depression in older adults with and without cognitive impairment

2018 ◽  
Vol 12 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Kornanong Yuenyongchaiwat ◽  
Khajonsak Pongpanit ◽  
Somrudee Hanmanop
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Older Individuals ◽  
Cross Sectional ◽  
Increased Risk

ABSTRACT Low physical activity and depression may be related to cognitive impairment in the elderly. Objetive: To determine depression and physical activity (PA) among older adults with and without cognitive impairment. Methods: 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. Results: A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Conclusion: Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

Correlation Between Depression and Cognitive Decline in Elderly Outpatients: A Preliminary Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S651-S651 ◽  
Author(s):  
A. Gogos ◽  
G. Papageorgiou ◽  
E. Kavourgia ◽  
E. Papakyrgiaki ◽  
A. Mitsokali
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptomatology ◽  
Symptomatic Relief ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Bipolar Patient ◽  
Hamilton Depression Scale ◽  
Elderly Outpatients

IntroductionDepressive disorder is common psychiatric morbidity among the elderly outpatients. It is also evident that cognitive disorders, ranging from mild cognitive impairment to severe dementia, are widely prevalent in the elderly coexistence of the above is quite common. Treatment for both conditions is quite challenging, aiming at symptomatic relief and improvement in functional status.ObjectivesTo investigate the coexistence of depression and cognitive impairment in aged depressive outpatients, 65 years or older. Correlation of cognitive level and depressive symptomatology was measured.MethodWe used hamilton depression scale (HAM-D) and MMSE in 35 (mean age 68.2 years) depressed outpatients over 65-year-old. We excluded depressed schizophrenics and bipolar patient.Results.On a preliminary basis, a correlation between low MMSe and HAM-D (P < 0.05) was found. An interesting finding, though not measured primarily, was that low MMSE was accompanied with a low compliance with medication.ConclusionsThe mental deterioration that accompanies cognitive impairment is being widely studied and it is real complex. In our ongoing study previous findings are confirmed and can be interpreted both ways, i.e. depression is a risk factor for dementia and also the fact that existing dementia is positively correlated with a low HAM-D.Compliance to medication is affected, among other variables, by the patients’ mental state.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Association between depressive syndrome and visual complaints among elderly caregivers

2018 ◽  
Vol 67 (4) ◽  
pp. 223-230
Author(s):  
Allan Gustavo Brigola ◽  
Mayara Caroline Barbieri ◽  
Bruna Moretti Luchesi ◽  
Eliane da Silva Grazziano ◽  
Regimar Carla Machado ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Functional Limitation ◽  
Depression Scale ◽  
The Elderly ◽  
Community Dwelling ◽  
Depressive Syndrome ◽  
Cross Sectional ◽  
Elderly Caregivers ◽  
Visual Complaints

ABSTRACT Objectives To determine depressive syndrome in community-dwelling elderly caregivers; and to test the association between such syndrome and both visual complaints (VC) and aspects of care. Methods This is a cross-sectional study conducted with 332 elderly caregivers. Geriatric Depression Scale (GDS-15) was used to screen for depressive symptoms (cutoff > 5 points). Logistic regression was performed to identify associations between depression and both VC and aspects related to care. Results Median age of the caregivers was 68 years. The majority was female (75.9%) and took care of a spouse (84.3%). The prevalence of depressive syndrome was 22.6%. The syndrome was associated with VC when it affected activities of daily living (OR = 2.4; 95% CI: 1.37-4.27) and caring for an individual with cognitive impairment (OR = 1.85; 95% CI: 1.05-3.26). Conclusions While measured aspects of care did not exert an influence on the incidence of depressive symptoms, VC associated to functional limitation and caring for elderly individuals with cognitive impairment was associated with such symptoms in the elderly caregivers.

scholarly journals Evaluation of Malnutrition and Depression in Elderly People: An Epidemiological Study in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
A Ünsal ◽  
D Arslantaş
Keyword(s):  
Health Care Providers ◽  
Nutritional Assessment ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cluster Sampling ◽  
Care Providers ◽  
Cross Sectional

Abstract Background Malnutrition is an important cause of morbidity and mortality. Malnutrition increases the number of hospitalizations and prolongs the length of hospitalization by disrupting organ functions, increasing the number and severity of infections and delaying wound healing. The aim of this study was to determine the frequency of suspected malnutrition in the elderly, to examine some related variables and to evaluate the depression. Methods The study is a cross-sectional study conducted between March-April 2019 in individuals aged 60 years and older living in Sivrihisar. Sample size was calculated as 579. Cluster sampling method used. Data was collected by door to door in 4 neighborhoods determined by randomly. Mini Nutritional Assessment Test-Short Form (for malnutrition), Katz Daily Living Activities Scale (for dependency) and Geriatric Depression Scale-Short Form (for depression) were used. Chi-square test, Mann Whitney U test and logistic regression analysis were used for the analyzes. Results The study group consisted of 220 (38%) women and 359 (62%) men. The mean age was 68.9±6.4 (ranged 60-93). Frequency of suspected malnutrition was 25% (n = 145). Being 80 years of age or older (OR:3.24, CI:1.53-6.85), having a primary and lower education level (OR:2.54, CI:1.32-4.90), history of chronic illness (OR:2.34, CI:1.33-4.03), using dentures (OR:1.62, CI:1.03-2.55) and suspected depression (OR:4.97, CI:3.17-7.78) are important risk factors for malnutrition. Those with suspicion of malnutrition had lower scores on DLA (z = 8.982;p=0.001). Conclusions Malnutrition was found to be an important health problem for the elderly. The frequency of suspected malnutrition is higher in individuals with depression. Those with suspected malnutrition have higher level of dependency. In order to reduce the frequency of malnutrition, it may be beneficial to increase the awareness of the elderly and caregivers and to give importance to the elderly nutrition of primary health care providers. Key messages Depression is an important risk factor for malnutrition. Malnutrition increases the dependence of the individual on daily activities.

Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Elderly Population ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Pressure Measurements ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Blood Pressures

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.

scholarly journals Correlation Between Level of Depression and Risk of Suicide in Elderly at Purwodadi, Grobogan

2020 ◽  
Vol 1 (2) ◽  
pp. 27-31
Author(s):  
Rilla Fiftina Hadi ◽  
Titis Hadiati ◽  
Natalia Dewi Wardani
Keyword(s):  
Rating Scale ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
The Elderly ◽  
Low Risk ◽  
Cross Sectional ◽  
Severity Rating ◽  
Central Java ◽  
Cross Sectional Design

Abstract Background: According to WHO, the elderly people have physical and mental challenges, including depression. The incidence of depression lead to suicide on elderly is about 12.7%. In Grobogan Regency, Purwodadi, Central Java, there has been an increase of depression in the last 5 years. Purwodadi Subdistrict depends on the number of orders with the highest number of traffic cases and the elderly.Objective: To determine the correlation between depression level and the risk of suicide.Methods: This research is a quantitative study with cross sectional design in which all respondents were observed and variables were measured at one time. Samples were taken from elderly outpatient of primary health care and Posyandu lansia at Purwodadi, who met the inclusion and exclusion criterias. Research samples were selected based on nonprobability sampling method through purposive sampling. This research used the Indonesian version of the GDS (Geriatric Depression Scale) and CSSRS (Columbia Suicide Severity Rating Scale) questionnaire.Results: The prevalence of elderly depression is 63.3%, and a significant correlation was found between severe depression and low risk of suicide (p <0.05)Conclusion: significant correlation was found between severe depression and low risk of suicide

scholarly journals Study on depression among elderly people in an urban slum of Raichur

2019 ◽  
Vol 6 (5) ◽  
pp. 2116 ◽  
Author(s):  
Vandana Ganganapalli ◽  
Sujatha N. ◽  
Bhaskar Kurre
Keyword(s):  
Elderly People ◽  
Nuclear Family ◽  
Adult Population ◽  
Elderly Person ◽  
Depression Scale ◽  
The Elderly ◽  
Short Version ◽  
Ageing Population ◽  
Cross Sectional ◽  
Prevalence Of Depression

Background: Globally, more than 300 million people of all ages suffer from depression. With an ageing population, depression among the elderly is likely to increase in the coming years, with higher prevalence among the elderly people than that in the general adult population. This study was intended to know the prevalence of depression and factors associated with depression among elderly people.Methods: A cross-sectional study was conducted in the urban field practice area of Navodaya Medical College, Raichur. A pre-designed and pre-tested questionnaire was used to interview the elderly person, after taking verbal consent. Depression was assessed using geriatric depression scale (short version). The study duration was from 1st September 2018 – 31st December, 2018 with 360 sample size.Results: Out of 360 elderly people, the prevalence of depression was found to be 31.4 %. The prevalence of depression was more in females 31.9% (63 out of 197). Significant association of depression was noted with age, socio-economic status, marital status, type of family, education and occupation with p<0.05.Conclusions: Around 1/3rd of the study participants were found to be suffering from depression. Depression was significantly associated with age, illiteracy, nuclear family, dependent on family members. Family support to the elderly population may prevent depression.

scholarly journals Prevalence of Mild Cognitive Impairment in Rural Thai Older People, Associated Risk Factors and their Cognitive Characteristics

2020 ◽  
Vol 10 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Jiranan Griffiths ◽  
Lakkana Thaikruea ◽  
Nahathai Wongpakaran ◽  
Peeraya Munkhetvit
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Older People ◽  
Significant Risk ◽  
Depression Scale ◽  
Cross Sectional ◽  
Factors Associated ◽  
Low Education ◽  
Rural Thailand

Introduction: Mild cognitive impairment (MCI) is a transitional stage between normal cognition and dementia. A review showed that 10–15% of those with MCI annually progressed to Alzheimer’s disease. Objective: This study aimed to investigate the prevalence and risk factors associated with MCI as well as the characteristics of cognitive deficits among older people in rural Thailand. Methods: A cross-sectional study in 482 people who were 60 years old and over was conducted in northern Thailand. The assessments were administered by trained occupational therapists using demographic and health characteristics, Mental Status Examination Thai 10, Activities of Daily Living – Thai Assessment Scale, 15-item Geriatric Depression Scale and the Montreal Cognitive Assessment-Basic (MoCA-B, Thai version). Results: The mean age of MCI was 68.3 ± 6.82 years, and most had an education ≤4 years. The prevalence of MCI in older people was 71.4% (344 out of 482), and it increased with age. Low education and diabetes mellitus (DM) were the significant risk factors associated with cognitive decline. Older people with MCI were more likely to have an education ≤4 years (RR 1.74, 95% CI 1.21–2.51) and DM (RR 1.19, 95% CI 1.04–1.36) than those who did not. The 3 most common cognitive impairments according to MoCA-B were executive function (86%), alternating attention (33.1%) and delayed recall (31.1%). Conclusion: The prevalence of MCI in older Thai people in a rural area is high compared with that in other countries. The explanation might be due to low education and underlying disease associated with MCI. A suitable program that can reduce the prospects of MCI in rural Thailand is needed.

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