scholarly journals Advanced age, constipation, depression: what are the ways of management?

2013 ◽  
Vol 20 (4) ◽  
pp. 57-59
Author(s):  
N. P. Chernus ◽  
L. A. Vinogradova ◽  
N. V. Kireeva
Keyword(s):  
Elderly People ◽  
Functional Constipation ◽  
Advanced Age ◽  
Kinetic Function ◽  
Educational Programmes ◽  
Microbiological Status ◽  
Group 1

Constipation is one of the key problems of modern therapy for elderly people. The research aim was to study the features of the psychological and microbiological status of the advanced and senile age patients with functional constipation and to see the effect of educational programmes on compliance of the patients with the therapy in the out!patient departments. The investigation showed that depression was more frequent in the patients of group 1 (68.4 % of the cases) with compensated function of the large gut whereas in the 2nd group – 34.6 % (compensated) and in the 3rd group – 41.5 % (subcompensated)cases. The 3rd degree dysbiosis was found in all patoents irrespective of the extern of disorder of the motor!kinetic function in the large gut.

Abstract 16929: Are Patients Implanted with a Ventricular Assist Device as Destination Therapy Created Equal? Analysis of Outcomes by Implant Indications

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Simon Maltais ◽  
Mary E Davis ◽  
Nicholas A Haglund ◽  
John A Schirger ◽  
Keith Aaronson ◽  
...  
Keyword(s):  
Adverse Events ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Advanced Age ◽  
Destination Therapy ◽  
Gi Bleeding ◽  
Assist Device ◽  
Ventricular Assist ◽  
Group 2 ◽  
Group 1

Introduction: A growing number of patients are implanted with a continuous-flow left ventricular assist device (CF-LVAD) for destination therapy (DT). Hypothesis: We sought to determine if indication for DT was associated with adverse events and survival. Methods: Between May 2004 and May 2014, 211 patients (age 66 (19-82), 89% male) underwent implantation of a HeartMate II CF-LVAD. The cohort was stratified according to primary listed indication for DT at time of implant: Group 1=advanced age (n=124, 59%); Group 2=high BMI (n=33, 16%), and Group 3=end-organ comorbidities (n=54, 25%). DT patients who later became BTT were eliminated for homogeneity. Results: Follow-up was available in all patients for a total of 376 patient-years of support (median 1.4 years). Preoperative characteristics (creatinine 1.5, INTERMACS 3, IABP 49%) were comparable between groups (all p>0.05). Overall 1, 3 and 5-year survival was 81%, 58%, and 41%, respectively. Kaplan-Meier analysis revealed comparable survival between groups stratified by DT indications (Figure, p=0.07). While gastrointestinal (GI) bleeding was more frequent in patients implanted for advanced age DT indications (p=0.01, group 1 vs group 2 and 3), the incidence of adverse events (pump thrombus/exchange, stroke) was comparable between groups. After adjusting for covariates (creatinine, hemoglobin, prior sternotomy and diabetes), Cox regression analysis demonstrated only preoperative renal dysfunction (HR 1.86 CI 1.28, 2.69; p=0.001) and lower Hemoglobin (HR 0.82 CI 0.71, 0.95; p=0.008) were associated with late mortality after implantation. Conclusions: Advanced age remains the most frequent contemporary indication for DT in patients undergoing CF-LVAD implantation. Indication for DT implantation does not influence long-term survival. Elderly patients may be at greater risk of GI bleeding events. These results continue to favor a uniform selection process across the spectrum of DT indications.

scholarly journals DETERMINING FACTORS IN THE SITUATIONAL TRANSITION OF FAMILY MEMBERS WHO CARE OF ELDERLY PEOPLE WITH PARKINSON'S DISEASE

2019 ◽  
Vol 28 ◽  
Author(s):  
Simony Fabíola Lopes Nunes ◽  
Angela Maria Alvarez ◽  
Maria Fernanda Baeta Neves Alonso da Costa ◽  
Rafaela Vivian Valcarenghi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Health Services ◽  
Physical Health ◽  
Family Support ◽  
Elderly People ◽  
Advanced Age ◽  
The Family ◽  
Elderly Caregivers

ABSTRACT Objective: to investigate the facilitator and inhibitory factors in the transition of elderly caregivers with Parkinson's disease. Method: a qualitative, exploratory and descriptive study, based on the family transition nursing theory developed with 20 elderly caregivers of elderly people with Parkinson 's disease, enrolled in the Associação Parkinson de Santa Catarina, from March to August 2015. To analyze and interpret the data, we used the thematic analysis of content proposed by Bardin, with the help of the ATLAS.ti software for data organization. Results: some factors were identified and considered as facilitators for the process of transition from the familiar to the exercise of the role of caregiver, such as: previous experiences as caregiver; spirituality and religiosity; family support network and health services. Other factors were identified as inhibiting factors for transition: emotional and physical health conditions; advanced age; personal life activities/commitments; family financial burden; and inadequate family support. It was observed that most family caregivers reported having previous experience in caring, having advanced age, and being able to care for the elderly with the disease. However, he considers his condition of emotional and physical health insufficient, resulting in overload. Lack of access to health services and family and financial support make it difficult to provide care. Conclusion: nurses should seek strategies to direct attention to facilitating factors in the family context in order to help the family to achieve well-being and healthy transition to the role of caregiver.

scholarly journals Tolerance and Effectiveness of Targeted Therapies in Aged Patients with Metastatic Melanoma

2021 ◽  
Author(s):  
Ondine Becquart ◽  
Bastien Oriano ◽  
Stéphane Dalle ◽  
Laurent Mortier ◽  
Marie Thérèse Leccia ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Elderly People ◽  
Targeted Therapies ◽  
Objective Response ◽  
Real Life ◽  
Standard Regimen ◽  
Aged Patients ◽  
Group 2 ◽  
Group 1

Purpose: Melanoma’s incidence is increasing, and elderly people could be significantly impacted since the majority occurs in people over 65 years of age. Combined targeted therapies (TT) are current standard regimen for BRAF mutated metastatic melanoma (MM). Except for subgroups of pivotal trials, little data are available for TT in this population. Materials and Methods: Outcomes were explored in real life patients from MelBase, a French multicentric biobank dedicated to the prospective follow-up of unresectable stage III or IV melanoma. Patients treated by BRAF TT and/or MEK TT combined or not, were included from 2013 to 2017 in 2 groups: group 1 <65-year-old (yo), group 2 >65 yo, analyzed for tolerance and efficacy. Results: 353 patients were included: 231 in group 1, 122 in group 2. Median follow-up was 12 months (M). Median time of treatment was 6.9 M. A total of 80% had at least one Adverse Effect (AE). Most frequent AE (all grades) were mainly skin and subcutaneous, general, and gastrointestinal disorders. A total of 31% of AE were grade 3–4: 28% in group 1 and 39% in group 2 (p = 0.05). No differences were observed in all AE grades proportion, dose modifications, interruptions, and discontinuations. For each group, median overall survival was 20.3 M (CI 95%: 15.5–27.9) and 16.3 M (CI: 14.5–26.9), respectively (p = 0.8). Median progression free survival was 7.8 M (6.4–9.9) and 7.7 M (CI: 5.8–11.3) (p = 0.4). Objective response rate was 59% and 50% (p = 0.6). Conclusion: This study on a large multicentric cohort is the first to assess that TT is well tolerated in elderly BRAF-mutated patients such as in patients younger than 65. Efficacy was similar between groups with outcomes reaching those from pivotal studies. There is thus no argument against using TT in elderly people, although an onco-geriatric opinion is welcome for the most vulnerable.

scholarly journals Tolerance and Effectiveness of Targeted Therapies in Aged Patients with Metastatic Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3042
Author(s):  
Ondine Becquart ◽  
Bastien Oriano ◽  
Stéphane Dalle ◽  
Laurent Mortier ◽  
Marie Thérèse Leccia ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Elderly People ◽  
Targeted Therapies ◽  
Objective Response ◽  
Real Life ◽  
Standard Regimen ◽  
Aged Patients ◽  
Group 2 ◽  
Group 1

Purpose: Melanoma’s incidence is increasing, and elderly people could be significantly impacted since the majority occurs in people over 65 years of age. Combined BRAF and MEK targeted therapies (TT) are current standard regimen for BRAF mutated metastatic melanoma (MM). Except for subgroups of pivotal trials, little data are available for TT in this population. Materials and Methods: Outcomes were explored in real life patients from MelBase, a French multicentric biobank dedicated to the prospective follow-up of unresectable stage III or IV melanoma. Patients treated by BRAF TT and/or MEK TT combined or not, were included from 2013 to 2017 in 2 groups: group 1 ≤ 65-year-old (yo), group 2 > 65 yo, analyzed for tolerance and efficacy. Results: 353 patients were included: 231 in group 1, 122 in group 2. Median follow-up was 12 months (M). Median time of treatment was 6.9 M. A total of 80% had at least one Adverse Effect (AE). Most frequent AE (all grades) were mainly skin and subcutaneous, general, and gastrointestinal disorders. A total of 31% of AE were grade 3–4: 28% in group 1 and 39% in group 2 (p = 0.05). No differences were observed in all AE grades proportion, dose modifications, interruptions, and discontinuations. For each group, median overall survival was 20.3 M (CI 95%: 15.5–27.9) and 16.3 M (CI: 14.5–26.9), respectively (p = 0.8). Median progression free survival was 7.8 M (6.4–9.9) and 7.7 M (CI: 5.8–11.3) (p = 0.4). Objective response rate was 59% and 50% (p = 0.6). Conclusion: This study on a large multicentric cohort is the first to assess that TT is well tolerated in elderly BRAF-mutated patients such as in patients younger than 65. Efficacy was similar between groups with outcomes reaching those from pivotal studies. There is thus no argument against using TT in elderly people, although an onco-geriatric opinion is welcome for the most vulnerable.

scholarly journals Dynamics of Quality of Life of Elderly People with Frailty and Parkinsonism under the Influence of Physical Therapy in the Postimmobilization Period after Radial Bone Fracture in a Typical Place

2021 ◽  
Vol 6 (1) ◽  
pp. 280-287
Author(s):  
Ostapyak Z. M. ◽  
◽  
Starodubtsev S. G. ◽  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Therapy ◽  
Elderly People ◽  
Bodily Pain ◽  
Sf 36 ◽  
Group 2 ◽  
Radial Bone ◽  
Group 1

In old age, due to the spread of age-related diseases, there are changes in the functioning of many organs and systems due to and against the background of polymorbidity, which affects the quality of life and requires correction. The purpose of the study was to determine the dynamics of the quality of life of elderly people with frailty and parkinsonism under the influence of physical therapy in the post-immobilization period after fracture of the radial bone in a typical place. Material and methods. We examined 27 elderly people with frailty and Parkinson's disease in the early postimmobilization period after fracture of the distal metaepiphysis of the radial bone (in a typical place). Group 1 engaged in the principles of outpatient rehabilitation with a predominance of preformed physical factors and group 2 engaged in a developed program of physical therapy, created in terms of patient-centric model of rehabilitation taking into account the specifics of each polymorbid condition using functional body training, massage, nutrition correction, expansion of social activity. The effectiveness of the program was evaluated in the dynamics before and after a month of implementation based on the results of the comparison of quality of life on the questionnaire "Medical outcomes study short form" (SF-36). 36 points were grouped into eight scales: Physical health: Physical Functioning, Role-Physical, Bodily Pain, General Health and Mental Health, Vitality, Social Functioning, Role-Emotional. Results and discussion. At the initial examination the examined people revealed a significant decrease in the results of all scales of physical and mental components of the quality of life of the questionnaire SF-36. The parameters of both groups did not differ statistically significantly (p> 0.05). At retesting, the difference between the results of the physical component of health in the primary and re-study on the physical functioning scale for individuals in group 1 was 18.9%, group 2 – 29.0%, role-physical – 19.8% and 35.5%, respectively, bodily pain – 12.3% and 33.1%, general health – 25.8% and 30.1%. The improvement of the mental component compared to the initial result on the vitality scales in patients of group 1 was 14,0%, group 2 – 27,4%, social functioning – 17,5% and 41,3%, respectively, role-emotional – 15,0% and 23,8%, mental health – 20,5% and 30,2%. The results of testing on all scales were statistically significantly better in individuals of group 1 compared with the result of group 2 (p <0,05). Conclusion. Elderly patients with polymorbid pathology and traumatic bone injuries require the development of pathogenetically based physical therapy programs taking into account and correcting the specifics of each disease, increases the overall effectiveness of rehabilitation and, consequently, quality of life

Frailty and Associated Risk Factors in Elderly People with Health Examination in Rural Areas of China

2020 ◽  
Author(s):  
Jie GU ◽  
Haiying CHEN ◽  
Xiaoqing GU ◽  
Xiaomin SUN ◽  
Zhigang PAN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly People ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Advanced Age ◽  
Health Examination ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Healthy Elderly ◽  
Epidemiological Characteristics

Background: Frailty is a common syndrome in elderly people, but has not been fully studied in China. We aimed to investigate the epidemiological characteristics of frailty and analyze its risk factors in elderly people in rural areas of China. Methods: This cross-sectional study was conducted between September and October 2016. Overall, 4323 elderly people over 60 yr were enrolled by cluster random sampling method from the Fengxian District of Shanghai, China. These subjects voluntarily participated in the health examination of the 2016 National Basic Public Health Service Program. In addition to regular examination items, frailty assessment was performed on the basis of Fried frailty phenotype criteria. Results: The prevalence of pre-frailty and frailty was 49.4% and 6.8%, respectively. Advanced age (OR=1.44 for pre-frailty and OR=2.01 for frailty, 65-74 years old; OR=3.02 for pre-frailty and OR=14.13 for frailty,75-84 years old; OR=8.17 for pre-frailty and OR=71.71 for frailty, ≥85 years old), female (OR=1.32 for pre-frailty and OR=1.97 for frailty), stroke history (OR=1.75 for pre-frailty and OR=2.43 for frailty), vision decrease (OR=1.98 for pre-frailty and OR=2.70 for frailty), and anemia (OR=1.95 for pre-frailty and OR=3.64 for frailty) were common risk factors for both pre-frailty and frailty. Conclusion: Healthy elderly people in the rural areas of Shanghai have relatively high prevalence of pre-frailty and frailty. Advanced age, female, stroke history, decreased vision, and anemia are the risk factors for pre-frailty and frailty.

P02-243 Life satisfaction, depression and spirituality for Korean elderly people

2011 ◽  
Vol 26 (S2) ◽  
pp. 839-839
Author(s):  
S.B. Lee
Keyword(s):  
Life Satisfaction ◽  
Elderly People ◽  
Well Being ◽  
The Elderly ◽  
Living Alone ◽  
Spiritual Well Being ◽  
Group 2 ◽  
Korean Elderly ◽  
Elderly Living ◽  
Group 1

AimThe purpose of this study was to assess Korean elderly people's residential condition with or without cohabitants, spouse and children, and to analyze their depression, spirituality and life satisfaction depending on residential condition.Methods160 subjects were randomly selected from one of religious organizations, Suwon City, Kyounggi Do, South Korea. The participants were divided into Group 1 (the elderly living alone: n = 74, Mean Age = 72.45, SD = 6.78) and Group 2 (the elderly living with spouse and/or children: n = 86, Mean Age = 72.12, SD = 6.82). The subjects participated in the survey forms of spiritual well-being, life satisfaction, and depression. It was hypothesized that the elderly living alone (Group 1) had lower scale in the areas of spiritual well-being, life satisfaction and higher scale in depression.ResultsThe t-test on the mean of each scale for the Group 1 and Group 2 was significant: Korean elderly people, who were living alone without family support, were less satisfied (p < .001), more depressed (p < .0001) and their spiritual well-being scale was lower (p < .001). For the total participants (n = 160). there was a positive correlation between spiritual well-being and life satisfaction (rho = .56, p < .001). There was negative correlation between depression and spiritual wellbeing (rho = −.67, p < .0001); depression and life satisfaction (rho = −.78, p < .0001).ConclusionFor the mental health professionals, including psychiatrists and gerontologists, it is important to understand the elderly people's residential situation, emotional support as well as to assess their life satisfaction and spiritual well-being in terms of quality of life measurement.

scholarly journals Does inguinal hernia repair increase urinary retention? Our 10-year results

2021 ◽  
Vol 8 (2) ◽  
pp. 449
Author(s):  
Ferec Efendiye ◽  
Haydar Celasin
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Urinary Retention ◽  
Operative Time ◽  
Fluid Replacement ◽  
Advanced Age ◽  
Number Of Patients ◽  
History Of ◽  
Group 1

Background: This study aimed to determine the incidence of urinary retention in patients undergoing inguinal hernia repair at our hospital as well as the predictors of urinary retention.Methods: Patients who underwent inguinal hernia repair at Lokman Hekim university Akay hospital between January 2010 and January 2020 were included in the study. The total number of patients was 578. The patients were divided into two groups: group-1 (patients who developed urinary retention following inguinal hernia repair) and group-2 (patients who did not develop urinary retention following inguinal hernia repair). The relationship between urinary retention and age, history of preoperative BPH, type and localization of hernia, operative and anesthesia time, perioperative NSAID, narcotic analgesic and antispasmodic use, presence of DM and rheumatic diseases and perioperative fluid replacement was investigated. Results: The median ages were 57.7±15.1 (20-74) and 48.8±17.5 (18-89) in groups 1 and 2, respectively (p<0.001).   5.36% (31/578) of the patients developed urinary retention. The group-1 were found to be at a more advanced age (p<0.001), have higher rates of BPH and DM (p<0.001), longer operative time (p<0.001), higher rate of perioperative antispasmodic use (p<0.001), higher rate of perioperative fluid replacement (p<0.001) and a lower rate of perioperative NSAID use (p<0.001) compared to those who did not develop postoperative urinary retention. Conclusions: According to the results of this study, advanced age, history of DM and BPH, antispasmodic use, longer operative time, high amount of postoperative fluid replacement and no perioperative use of NSAIDs lead to an increased risk of urinary retention.

scholarly journals Clinical and Psychopathologic Features of Depression in Organic Cerebropathies in Elderly People

Doctor Ru ◽  
2021 ◽  
Vol 20 (9) ◽  
pp. 54-59
Author(s):  
M.A. Kinkulkina ◽  
◽  
Yu.G. Tikhonova ◽  
A.V. Lazareva ◽  
V.P. Sysoeva ◽  
...  
Keyword(s):  
Elderly People ◽  
Affective Disorders ◽  
Rating Scale ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
Disease Manifestation ◽  
Study Objective ◽  
Study Results ◽  
Group 2 ◽  
Group 1

Study Objective: Comprehensive study of the clinical and psychopathologic structure and assessment of the affective disorder nosology in organic cerebropathies in elderly people. Study Design: observational comparative clinical study. Materials and Methods. We have examined 105 patients over 50 years old (mean age: 61.3 ± 7.6 years) with affective disorders and organic cerebropathies (F06; F30–39; F43). Subjects were divided into two groups: 49 patients with organic central nervous system (CNS) diseases and prevailing affective symptoms in their psychoorganic syndrome (Group 1); 56 patients with affective disorders and an organic cerebropathy late in their life (Group 2). We used the clinical psychopathologic method, Montgomery – Asberg Depression Rating Scale, Hospital Anxiety and Depression Scale, and Mini Mental State Examination. Study Results. Significant differences were found in the distribution of the primary etiological factor of organic cerebropathies. Group 1 had mostly mixed etiology (42.8%), while Group 2 had toxic CNS damages (33.9%). There were large intergroup differences in affective disease nosology: Group 1 patients had mostly organic depressions (51.2%), and recurrent depressions (36.7%). Group 2 patients had recurrent depressions and bipolar effective disorders. Significant differences were found in the age of disease manifestation (54.8 and 39.4 years, respectively, р < 0.001) and disease duration (6.5 and 19.9 years, р < 0.001). Group 1 patients had mostly chronic and recurrent depressions, while Group 2 patients had bipolar and recurrent disease (р < 0.001). The number of past depressive events differed a lot as well: 3.1 and 6.4 (р = 0.03). Group 2 patients had more cases of severe dreary and anergic depression. Conclusion. Clinical and psychopathologic features of affective disorders in organic cerebropathies in elderly people are polymorphic symptoms, including various ratios of depressive and psychoorganic syndromes. Depressions in elderly people with organic cerebropathies have their distinguishing structure, clinical course and require a number of additional diagnostic examinations and division into two types depending on the relation between the time of affective pathology onset and organic cerebropathies. Keywords: depression in elderly people, late depression, organic cerebropathies, affective disorders, cognitive disorders.

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