scholarly journals Effect of comorbidities and polypharmacy on fall risk among older adults

Hand F Mahmoud ◽  
Hebatullah EMZ Elmedany

Introduction: Fall is considered by far one of the leading causes of morbidity and mortality in the elderly population. Fall is almost always multifactorial. This study looks into the relation between different comorbidities, polypharmacy and falls.Methods: A descriptive and prospective study, the study population comprised 150 elderly patients aged > 60 years old, males and females, patients with previous history of falls are excluded. Comorbidity burden, polypharmacy and risk of falls were assessed.Results and Discussion: There was a significant positive correlation between Number of comorbidities, medications and risk of falls and there was a significant association between high risk of falls and presence of DM, PVD, OLD CVA and UI. Also, there was a significant positive correlation between age and risk of falls.Conclusion: Multiple comorbidities, polypharmacy and increasing age increase risk of falls.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 75-79

2015 ◽  
Vol 2 (2) ◽  
Nitin R. Korat ◽  
Mohit M. Pandya

The purpose of present study was to find out correlation between the Adjustment and their Psychological well-being among of Call center employees. The said sample was 240 both males and females in equal numbers was selected through random sampling. Adjustment Inventory &Psychological well-being Inventory are tailor-made instruments, having sufficient reliability and validity. For the purpose of analysis, The Karl-Pearson „r‟ technique was used. Present study reveals the result that there is significant Positive correlation between the Adjustment and Psychological well-being among of Call center employees. The authors suggest that there is a need to explore the rural and the urban correlation in the line of above study.

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
J. Packer ◽  
M. A. Hussain ◽  
S. H. A. Shah ◽  
J. R. Srinivasan

Aims. To study the factors associated with the DSH in the elderly group of 60 years and above and to recommend changes to be implemented in order to improve the management in this specific group. Materials and Methods. Five-year retrospective study was undertaken from July 2005 to July 2010 in the Plastic Surgery Department of the Royal Preston Hospital, NHS Trust. A Performa was designed to collect data about the inpatient admission and included certain areas of key information. The case notes for all patients were extensively analysed in order to gather adequate information for the devised Performa. Results. DSH is getting more common in the elderly group, and males are more affected than females. 60% of the patients had a previous history of DSH. A large number (80%) of patients had a previous history of mental illness. 60% of those DSH patients were living with family. Almost all patients (90%) were reviewed by the Psychiatry Liaison Team. The timing of patients being assessed was highly variable. Conclusions. Marriage is not a protective factor in the prevention of the DSH in the elderly group. A mental health team referral in the early phases of the management would be of huge benefit and a likely step to prevent possible future admissions. The Department would benefit from the creation of a protocol for the management of these patients. There should be a joint effort of the professionals in the management of DSH in the elderly, and GPs play a very important role in the prevention of DSH in the later life.

2013 ◽  
Vol 31 (4) ◽  
pp. 308-312 ◽  
Sérgio Nuno Craveiro Barra ◽  
Luís Vilardouro Paiva ◽  
Rui Providência ◽  
Andreia Fernandes ◽  
António Leitão Marques

AimsAlthough it is accepted that atrial fibrillation (AF) may be both the contributing factor and the consequence of pulmonary embolism (PE), data on the prognostic role of AF in patients with acute venous thromboembolism are scarce. Our aim was to study whether AF had a prognostic role in patients with acute PE.MethodsRetrospective cohort study involving 270 patients admitted for acute PE. Collected data: past medical history, analytic/gasometric parameters, admission ECG and echocardiogram, thoracic CT angiography. Patients followed for 6 months. An analysis was performed in order to clarify whether history of AF, irrespective of its timing, helps predict intrahospital, 1-month and 6-month all-cause mortality.ResultsPatients with history of AF, irrespective of its timing (n=57, 21.4%), had higher intrahospital (22.8% vs 13.1%, p=0.052, OR 2.07, 95% CI 0.98 to 4.35), 1-month (35.1% vs 16.9%, p=0.001, OR 3.16, 95% CI 1.61 to 6.21) and 6-month (45.6% vs 17.4%, p<0.001, OR 4.67, 95% CI 2.37 to 9.21) death rates. The prognostic power of AF was independent of age, NT-proBNP values, renal function and admission blood pressure and heart rate and additive to mortality prediction ability of simplified PESI (AF: p=0.021, OR 2.31, CI 95% 1.13 to 4.69; simplified PESI: p=0.002, OR 1.47, CI 95% 1.15 to 1.89). The presence of AF at admission added prognostic value to previous history of AF in terms of 1-month and 6-month all-cause mortality prediction, although it did not increase risk for intrahospital mortality.ConclusionsThe presence of AF, irrespective of its timing, may independently predict mortality in patients with acute PE. These data should be tested and validated in prospective studies using larger cohorts.

2021 ◽  
Rongsheng Xie ◽  
Siting Hong ◽  
Guoliang Gao ◽  
Jiaoyue Zhong ◽  
Lixin Geng ◽  

Abstract BackgroundArrhythmias are potential harmful diseases to human beings, especially atrial fibrillation and ventricular arrhythmia, for causing serious consequences such as acute stroke or even sudden cardiac death. Recently the screening of asymptomatic atrial fibrillation by using the long-term ECG monitoring has been widely noticed. The study is to evaluate the significance of detective arrhythmia by using the long-term ECG monitoring in the elderly “so called” healthy people who never have the symptoms of palpitation, short breath or deny previous history of arrhythmia.MethodsWe enrolled a screening study of 1056 participants who were the elderly “so called” healthy people and ready to have a healthy examination from three different communities. They all underwent a long-term ECG monitoring(an adhesive patch)to evaluate cardiac arrhythmia. Inclusion criterias were 1) without any symptoms, 2) age ≥55, and 3) denying previous history of arrhythmia. We excluded patients with prior arrhythmias and who carried the patch for less than one day due to various factors. Then we compared the detected arrhythmia events in the first 24 hours and the total wearing time. ResultsOut of 1056 participants (69.8±12.0 years, 620 males), supraventricular tachycardia (SVT) was present in 538 subjects (44% VS 54%, 24 hours VS after 24 hours, P>0.05), atrial fibrillation (AF) was detected in 69 subjects (75% VS 25%, 24 hours VS after 24 hours, P<0.001), second degree type II atrioventricular block/third degree atrioventricular block (AVB) and sinus arrest were detected in 9 subjects(22% VS 78%, 24 hours VS after 24 hours, P<0.001),ventricular tachycardia was detected in 29 subjects (31% VS 69%, 24 hours VS after 24 hours, P<0.001). The adhesive patch monitor detected 32.10%(339/1056)arrhythmia events over the first 24 hours compared with arrhythmia events over the total wearing time of the devices, 61.08%(645/1056)(P<0.001). ConclusionsThe long-term adhesive patch monitor (APM) can improve the diagnosis of conceal arrhythmias which have high risks for life quality and lifespan in the elderly “so called ” healthy people, and the diagnostic advantage in bradycardia and ventricular arrhythmias are more obvious.

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 75-75
Michael Polson ◽  
Chuck Yonan ◽  
Ted Williams

AbstractBackgroundTardive dyskinesia (TD) is a movement disorder associated with prolonged exposure to antipsychotics. The current study was designed to describe demographics and comorbidities for patients with a dyskinesia diagnosis as probable TD (cohort 1), patients likely to have undiagnosed/uncoded TD (cohort 2), and a control population.MethodsThis retrospective study analyzed Medicaid claims data from July 2013-March 2017. For a pool of patients with a history of 3 months or more of taking an antipsychotic, three cohorts were evaluated: cohort 1 (ICD-9/10 codes for dyskinesia); cohort 2 (propensity score matching to cohort 1); and cohort 3 (patients withschizophrenia, major depressive disorder [MDD], and/or bipolar disorder [BD] and history of ≤2 antipsychotic medications). Outcomes included patient characteristics, Charlson Comorbity Index (CCI) and healthcare utilization (pre-and post [12-month] period).ResultsCohort sizes and characteristics were: cohort 1 (n=1,887; female, 68%; mean age, 42 years; MDD, 17%; BD, 48%); cohort 2 (n=1,572; female, 58%; mean age, 39 years; MDD, 22%; BD, 48%); cohort 3 (n=25,949; female, 67%; mean age, 40 years; MDD, 11%; BD, 49%). Cohorts 1 and 2 had higher comorbidity burden than cohort 3 (mean pre-index CCIs: 0.68, 0.79, and 0.47, respectively; p<0.001 for each cohort). After 12 months, mean per member per year healthcare costs were higher in cohort 1 and2 compared to cohort 3 ($21,293, $18,988, and $11,522, respectively), as were mean claims per member per year (185, 138, and 109, respectively).ConclusionIn the study population, patients likely suffering from TD, ICD-9/10 code-confirmed or unconfirmed, have a higher overall comorbidity burden and healthcareutilization than those who probably do not have TD.Funding AcknowledgementsThis study was funded by Neurocrine Biosciences, Inc.

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Tudor Vagaonescu ◽  
Alan C Wilson ◽  
John B Kostis

Background: To assess if diuretic-based antihypertensive treatment improves long term fatal (cardiovascular) outcomes in the elderly with isolated systolic hypertension (ISH) and ECG documented left ventricular hypertrophy (LVH). Methods: Retrospective analysis of the SHEP database of 4,736 patients age ≥60 years and ISH and subsequent vital status ascertainment by matching to the National Death Index. Results: 348 subjects (7.35%) of SHEP participants had ECG documented LVH at baseline. Subjects with LVH had at baseline: higher SBP and pulse pressure (p<0.0001), carotid bruits (13% vs. 7%, p<0.0001) and previous history of myocardial infarction (8% vs. 4%, p=.0008) when compared with participants without LVH. There were no significant differences with regard to age, sex, heart rate, body mass index, smoking and alcohol use, previous history of stroke, diabetes, angina, and assignment to treatment or placebo group. Over 14.3 years (mean) of follow up subjects with baseline LVH experienced significantly more all cause mortality (51% vs. 40%, p<0.0001) and cardiovascular death (24% vs. 19%, p=0.002) than participants without baseline LVH. In the group of participants with LVH at baseline active treatment of hypertension did not decrease all cause mortality (51% vs. 50%, NS) or cardiovascular death (26% vs. 24%, NS). There was no statistically significant interaction between LVH and the assignment to treatment (antihypertensive medication vs. placebo). In a multivariable analysis, the adjusted Cox hazard ratio of developing any fatal outcome in the LVH group was 1.181 (95% CI 1.005–1.387, p=0.043) after adjusting for age, sex, race, history of myocardial infarction, diabetes, alcohol smoking status, education, blood pressure, and assignment to treatment or to placebo group. Conclusion: In the elderly with ISH the presence of LVH documented by ECG increased the risk for long term fatal outcomes despite treatment with diuretic-based antihypertensive therapy. Although active treatment lowered risk in the SHEP study, treated participants with LVH had a higher risk for fatal outcomes than treated subjects without LVH.

2018 ◽  
Vol 32 (04) ◽  
pp. 337-343 ◽  
Samuel Rosas ◽  
T. Luo ◽  
Alexander Jinnah ◽  
Alejandro Marquez-Lara ◽  
Martin Roche ◽  

AbstractRisk factors for adverse events after total knee arthroplasty (TKA) relating to malignancy have not been well studied. Thus, the purpose of this study was to conduct a retrospective case–control outcome and cost analysis after TKA in this population. Patients with a history of breast cancer (BrCa) were identified based on the International Classification of Disease 9th revision codes. An age- and sex-matched cohort was also identified of patients without a history of BrCa. Complications, length of stay, comorbidity burden, and reimbursements were tracked at 90 days. Each cohort comprised 92,557 patients. Length of stay was similar between cohorts (p = 0.627). Comorbidity status and incidence of pulmonary embolism (PE), lower extremity ultrasound, and chest computed tomography (CT) use were higher in patients with a history of BrCa (p < 0.05 for all). Control patients had a lower incidence of acute myocardial infarction (0.14 vs. 0.21%; p < 0.001). Surgical complications were similar. The 90-day reimbursements were greater in patients with a history of BrCa (US$13,990 vs. US$13,033 for controls; p = 0.021). Surgeons should be aware of the increased risk of PE after TKA in patients with a history of BrCa as well as increased 90-day costs, which warrant great attention.

الملخص : هدفت الدراسة إلى التعرف على تمكين العاملين وعلاقته بتعزيز ثقافة الإنجاز لدى العاملين في بلدية دير البلح. يتكون مجتمع الدراسة من جميع العاملين في بلدية دير البلح والبالغ عددهم (117) عاملاً، وتم اختيار عينة الدراسة من جميع العاملين باستثناء قطاع الخدمات حيث بلغ عددهم (65) عاملاً. ولتحقيق أهداف الدراسة طورت استبانة لجمع البيانات، واستخدم المنهج الوصفي التحليلي للتوصل إلى نتائج الدراسة والتي كان من أهمها: وجود علاقة طردية ذات دلالة إحصائية بين تمكين العاملين وتعزيز ثقافة الانجاز لدى العاملين في بلدية دير البلح، وتوصي الباحثة بضرورة التنوع في أشكال تمكين العاملين المقدمة من قبل بلدية دير البلح (تفويض الصلاحيات، المعرفة والمعلومات، والتدريب والتطوير)، بالإضافة إلى الاهتمام بتطوير العاملين عن طريق منحهم برامج تدريبية تتميز بالحداثة وعدم التكرار. Abstract The study aimed to identify the relationship between empowerment of employees and the culture of achievement among the employees of the municipality of Deir al-Balah. The study population consisted of all the employees of the municipality of Deir al-Balah with a total number of (117) employees. The sample of the study included all the employees except those working in the service sector, with a total number of (65) employees. In order to achieve the objectives of the study, a questionnaire was developed to collect the data, and the descriptive analytical method was used to reach the study results. The main results indicated the existence of a significant positive correlation between the empowerment of employees and the promotion of culture of achievement among the employees of the municipality of Deir al-Balah. The researcher recommends the need for a diversity in the ways of empowerment of employees provided by the municipality of Deir al-Balah (assignments of authorities, knowledge and information, training and development) in addition to building the capacity of the employees by offering them modern training programs with no repetition.

1976 ◽  
Vol 24 (4) ◽  
pp. 159-168 ◽  
Jan Perney

In order to provide information concerning the development of musical concepts in young children, musical tasks related to Piaget's concept of conservation of metric time were presented to second- and third-grade children. The results indicated that children who played musical instruments did not perform significantly better than their peerswho did not play musical instruments. Second, females were found to be superior to males in performing the tasks. Third, there was a significant positive correlation between performance on the musical tasks and verbal ability for both males and females. Finally, it was found that little support could be given to the idea that conservation of metric time develops in an invariant sequence.

Sign in / Sign up

Export Citation Format

Share Document