NEW APPROACHES TO THE OLD PROBLEMS. HYPERTENSION IN THE GERIATRIC PATIENTS

2020 ◽  
pp. 515-526
Author(s):  
Е. А. Темникова ◽  
А. И. Кондратьев ◽  
М. В. Темников
Keyword(s):  
Old Age ◽  
Elderly Population ◽  
Geriatric Patients ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
Noncommunicable Diseases ◽  
The World ◽  
Very Old Age ◽  
Modern Information ◽  
The Impact

Значительное увеличение численности лиц пожилого и старческого возраста во всём мире ведёт к возрастанию актуальности проблем сохранения здоровья и адекватной медицинской помощи гериатрическим пациентам. Особое значение приобретают своевременная диагностика и лечение хронических неинфекционных заболеваний, частота которых с возрастом значительно нарастает. Артериальная гипертензия в пожилом и старческом возрасте всегда вызывала особое внимание исследователей и практических врачей из-за её распространённости, меняющихся подходов к диагностике и оценке влияния на прогноз, различающихся неоднозначных предложений по ведению возрастных пациентов. В обзоре представлены данные международных и отечественных исследований и рекомендаций по вопросам патофизиологии артериальной гипертензии, особенностям её диагностики и лечения в различных клинических ситуациях. A significant increase of the elderly population over the world leads to an increasing the relevance of the problems of maintaining health and adequate medical care for geriatric patients. Timely diagnosis and treatment of chronic noncommunicable diseases, the frequency of which increases with age, have been the particular importance. The researchers and practicing doctors have always paid special attention to hypertension in old and very old age due to its prevalence, changeable approaches to diagnosis and assessment of the impact on the prognosis, various ambiguous proposals for the management of the patients. Modern information about the international and domestic researches and recommendations on the issues of the pathophysiology of hypertension, features of its diagnosis and treatment in various clinical situations is presented in the review.

scholarly journals Prevalence and comparison of depression rates in geriatric patients of old age home and community, and its association with chosen demographic factors

2020 ◽  
Vol 8 (5) ◽  
pp. 1760
Author(s):  
Preksha T. Singh ◽  
Shreyans D. Singhvi ◽  
Gautam Bhandari
Keyword(s):  
Old Age ◽  
Elderly Population ◽  
Geriatric Patients ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Demographic Factors ◽  
Educational Status ◽  
The Elderly ◽  
Health Condition ◽  
Geriatric Depression

Background: Depression is an emerging mental health condition and elderly population of the world is often affected by it. In the elderly, it often goes unnoticed and often burdens them.Methods: Two groups of population one from an old age home and the other from a community were selected. Data was collected using a Geriatric Depression Scale (GDS) and a demographic form. The data was compiled and analyzed using Google Spreadsheets.Results: Depression rates were found in both, the old age home and the community. The rates were found higher in the old age home than the community. The demographic factors chronic illness, gender, educational status and marital status were found to be associated with depression.Conclusions: As depression in elderly is a fairly common phenomenon, it should be paid more attention. The elderly should receive intervention for the disease and be able to sustain it.

scholarly journals Prevalence and determinants of depression among old age: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yosef Zenebe ◽  
Baye Akele ◽  
Mulugeta W/Selassie ◽  
Mogesie Necho
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Old Age ◽  
Elderly Population ◽  
Meta Analysis ◽  
Group Analysis ◽  
The Elderly ◽  
Effective Control ◽  
Prevalence Of Depression ◽  
The World

Abstract Background Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. It is also one of the most common geriatric psychiatric disorders and a major risk factor for disability and mortality in elderly patients. Even though depression is a common mental health problem in the elderly population, it is undiagnosed in half of the cases. Several studies showed different and inconsistent prevalence rates in the world. Hence, this study aimed to fill the above gap by producing an average prevalence of depression and associated factors in old age. Objective This study aims to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression and its determinants among old age. Method A comprehensive search of PubMed, Scopus, Web of sciences, Google Scholar, and Psych-info from database inception to January 2020. Moreover, the reference list of selected articles was looked at manually to have further eligible articles. The random-effects model was employed during the analysis. Stata-11 was used to determine the average prevalence of depression among old age. A sub-group analysis and sensitivity analysis were also run. A graphical inspection of the funnel plots and Egger’s publication bias plot test were checked for the occurrence of publication bias. Result A search of the electronic and manual system resulted in 1263 articles. Nevertheless, after the huge screening, 42 relevant studies were identified, including, for this meta-analysis, n = 57,486 elderly populations. The average expected prevalence of depression among old age was 31.74% (95% CI 27.90, 35.59). In the sub-group analysis, the pooled prevalence was higher among developing countries; 40.78% than developed countries; 17.05%), studies utilized Geriatrics Depression Scale-30(GDS-30); 40.60% than studies that used GMS; 18.85%, study instrument, and studies having a lower sample size (40.12%) than studies with the higher sample; 20.19%. Conclusion A high prevalence rate of depression among the old population in the world was unraveled. This study can be considered as an early warning and advised health professionals, health policymakers, and other pertinent stakeholders to take effective control measures and periodic care for the elderly population.

scholarly journals Health risk assessment and countermeasure analysis of the elderly population exposed to PM2.5 microenvironment

Work ◽  
2021 ◽  
pp. 1-11
Author(s):  
Yan Xu ◽  
Wantian Cui
Keyword(s):  
Mental Health ◽  
Health Risk ◽  
Elderly Population ◽  
Mental Health Problems ◽  
Negative Impact ◽  
The Elderly ◽  
Exposure Concentration ◽  
Physical Diseases ◽  
The Impact

BACKGROUND: China’s atmospheric PM2.5 pollution is serious, and PM2.5 exerts a negative impact on the human respiratory system, cardiovascular, and mental health, and even more serious health risk for the elderly with weak immunity. OBJECTIVE: This work aims to analyse the impacts of PM2.5 microenvironment exposure on the health of the elderly and provide corresponding countermeasures. METHODS: The survey subjects are 118 retired elderly people in the community. PM2.5 exposure concentrations are monitored in summer (June 10 ∼ July 10, 2019) and winter (November 25 ∼ December 25, 2019). RESULTS: The exposure concentration in winter is higher than that in summer, with statistical difference (P <  0.05). Under the impact of PM2.5 microenvironment exposure, smoking in the elderly can increase the concentration of PM2.5, and long-term exposure to PM2.5 in the elderly can cause mental health problems. CONCLUSION: Long-term exposure of the elderly to the PM2.5 microenvironment leads to physical diseases and even psychological problems, which requires attention.

scholarly journals A comparative study of the voice-related quality of life among Egyptian elderly with and without voice complaints

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Nesreen Fathi Mahmoud ◽  
Huda Zahran ◽  
Sherif Abdelmonam
Keyword(s):  
Quality Of Life ◽  
Elderly Population ◽  
Life Quality ◽  
Voice Disorders ◽  
The Elderly ◽  
Different Types ◽  
Related Quality ◽  
The Impact ◽  
The Voice

Abstract Background This study focuses on the self-perception of the voice in the elderly as assessed by the Voice-Related Quality of Life (V-RQOL) questionnaire. This work aimed to compare differences in the voice-related quality of life outcomes between (1) elderly with and without voice disorders, (2) female and male elderly with voice disorders, and (3) different types of voice disorders, and to explore the correlation between the V-RQOL and perceptual analysis done by the clinician. Forty-three dysphonic and 44 non-dysphonic elderly filled out the Voice-Related Quality of Life (V-RQOL) protocol that analyzes the impact of dysphonia on life quality. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by a flexible nasofibrolaryngoscope. Results A significant statistical difference was found between the means of total V-RQOL scores and its subdomains for each group (dysphonic and non-dysphonic). No significant differences were found between male and female elderly with dysphonia. The statistical analysis showed a significant correlation with the vocal assessment made by the clinicians and the V-RQOL self-assessment made by the subjects. Conclusions This study provides valuable information regarding the risk factors that contribute to vocal quality in the elderly population. Our results revealed that different types of voice disorders are common among the elderly population with significant negative effects on quality of life. It was observed that the poorest score on the V-RQOL was for functional voice disorders, followed by neoplastic lesions, whereas MAPLs had the best score on the V-RQOL.

scholarly journals Elderly and drugs: risks and necessity of rational use

2010 ◽  
Vol 46 (4) ◽  
pp. 617-632 ◽  
Author(s):  
André de Oliveira Baldoni ◽  
Farah Maria Drumond Chequer ◽  
Elisa Raquel Anastácio Ferraz ◽  
Danielle Palma de Oliveira ◽  
Leonardo Régis Leira Pereira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Effects ◽  
Elderly Population ◽  
Adverse Drug Events ◽  
The Elderly ◽  
External Factors ◽  
Access To Information ◽  
Inappropriate Use ◽  
The World

In recent decades, the world has undergone a demographic transformation with a rapid growth of the elderly population, resulting in an increased demand for funds to maintain their health and drug consumption. Pharmacokinetic and pharmacodynamic changes occurring in the elderly can interfere directly in the adverse effects of drugs and increase the risk of intoxication. In addition, there are external factors interfering with the pharmacotherapy of the elderly, such as inappropriate use and the lack of access to information. Many therapeutic classes of drugs should be used with caution or avoided in the elderly population, such as anti-inflammatory and some anti-hypertensive drugs, diuretics and digitalis. If not managed carefully, these medicines can affect the safety and quality of life in the elderly. Thus, the aim of this review was to identify drugs that should be used with caution in elderly patients in order to avoid intoxication and/or adverse drug events.

scholarly journals Use of Music Therapy as an Audiological Rehabilitation Tool in the Elderly Population: A Mini-Review

2021 ◽  
Vol 15 ◽  
Author(s):  
Anne Sophie Grenier ◽  
Louise Lafontaine ◽  
Andréanne Sharp
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Music Therapy ◽  
Cognitive Decline ◽  
Social Participation ◽  
Cognitive Abilities ◽  
Elderly Population ◽  
Vestibular Function ◽  
The Elderly ◽  
The Impact

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.

scholarly journals ROLE OF TRIVIDHA ROGAYATANA IN THE MANIFESTATION OF ESSENTIAL HYPERTENSION W.S.R. TO PRAGYAPARADA - A CONCEPTUAL STUDY

2021 ◽  
Vol 9 (8) ◽  
pp. 1733-1736
Author(s):  
Ajay Kumar Nigwal ◽  
Lajwanti Keswani ◽  
Rajesh Kumar Malviya ◽  
Arvind Kumar Yadav
Keyword(s):  
Elderly Population ◽  
Antihypertensive Drugs ◽  
Adult Population ◽  
The Elderly ◽  
Elevated Blood ◽  
The World ◽  
Causes Of Disease ◽  
Conceptual Study ◽  
Day By Day

Cardiovascular disease such as hypertension will be the largest cause of death and disability in India by 2020. The prevalence of hypertension is increasing globally and currently, more than 1 billion people have hypertension. About 26.4% of the world adult population in 2000 had hypertension and 29.2% were projected to have this con- dition by 2025. Elevated blood pressure affects 1 billion individuals and causes an estimated 10.4 million deaths per year. Thus, hypertension is needed to be studied. Though a lot of potent antihypertensive drugs are available today none of them is free from untoward adverse effects. Especially the elderly population poorly tolerates these drugs. The global incidence of hypertension is increasing day by day and is a very common problem nowadays. Ayurveda has classified the causes of disease into three main categories: - 1. Asatmendriyartha Samyoga 2. Pragyaparada and 3. Parinama (Kaala), these three main causes of disease enable different kinds of diseases to manifest. Firstly, they lead to the imbalance of body /or mind by vitiation the Tridosha. The consequence of the imbalance is a disturbance of the basic biological principles. Hypertension is a lifestyle disorder. Ayurveda causes of lifestyle disorders are mainly Pragyaparada. Pragyaparadha is the main cause of all noncommunicable dis- eases (NCDs) such as diabetes, cancer, hypertension etc. Keywords: Asatmendriyartha, Pragyaparada, Parinama, Trividha Rogaayatanas, Hypertension.

scholarly journals Characteristics of geriatric neurology patients treated at the central hospital of Sanglah Denpasar in 2019

2020 ◽  
Vol 7 (2) ◽  
pp. 245
Author(s):  
Stephanie Elizabeth Gunawan ◽  
Anak Agung Ayu Putri Laksmidewi
Keyword(s):  
Medical Records ◽  
Elderly Population ◽  
Neurological Diseases ◽  
Head Injuries ◽  
Elderly Person ◽  
The Elderly ◽  
World Health ◽  
Central Hospital ◽  
The World ◽  
Health Organization

Background: According to the World Health Organization (WHO), an elderly person is someone who has entered the age of 60 years and above whose percentage tends to increase along with decreasing morbidity of the elderly. Geriatric Neurology itself is the study of a group of neurological diseases in the elderly. Based on 2012 data, the proportion of elderly population in Indonesia is 7.59%. This is accompanied by an increase in the dependency ratio of the productive age population to the non-productive age population. The results of the 2013 Basic Health Research showed an increase in the prevalence of neurological disease in the elderly which was the main cause of death in 15 regencies in 2011. It is to find out the 5 most neurological diseases in the elderly, clinical characteristics and outcomes of geriatric neurology patients treated at the Central Hospital of Sanglah.Methods: It is a retrospective study using no control by looking at medical records in geriatric neurology patients aged 60 years and over who visited the Central Hospital of Sanglah in the March to May 2019 period.Results: A total of 200 patients consisted of 111 men (55.5%) and 89 women (44.5%) who were divided into 5 most geriatric neurology diseases which included 1. ischemic stroke, 2. bleeding stroke, 3. brain tumor, 4. injury head, and 5. epilepsy. The number of deaths was 16, of which 7 cases were caused by sepsis and pneumonia.Conclusions: Stroke, tumors, head injuries and epilepsy are the dominant neurological diseases found. The focus of care and supervision of elderly neurology patients is expected to be further enhanced to prevent side effects that will extend the patient’s treatment period in the hospital which will automatically increase the burden on the hospital itself.

scholarly journals Services for the Elderly in Israel: Privatization or Nationalization-An Unending Dilemma-A Reflection

2019 ◽  
Vol 7 (3) ◽  
pp. 54
Author(s):  
Avi Bitzur ◽  
Mali Shaked
Keyword(s):  
Old Age ◽  
Aging In Place ◽  
Elderly Person ◽  
The Elderly ◽  
Baby Boomer Generation ◽  
The World ◽  
Health Related ◽  
Basic Concepts ◽  
The Government ◽  
The One

The world in which we live is aging at a dizzying pace and expressions like “70 is the new 50” or the creation of concepts such as the “Silver Tsunami”, a nickname for the aging baby-boomer generation, have become an inseparable part of the reality in our society.On the one hand, the spread of aging is a welcome phenomenon – a sort of solution to the great human effort to reach immortality. On the other hand, however, old age can be perceived as a period burdened by economic, social and health-related challenges and it is becoming more and more clear that throughout the world, and in Israel in particular – the focus of this article - we must begin to prepare systems and services for the provision of rapid and comprehensive solutions for the tsunami of aging that befalls us. This stems from an understanding that the services we have in place today are not sufficiently prepared to handle the range of challenges and issues that will arise as a side effect of this phenomenon.The dilemmas that come hand in hand with the aging of our population are innumerable, however five particular issues stand out: the first is who should be responsible for the elderly and their care – the government or the person’s family? The second: Should all of the elderly receive the same care or should the treatment assistance vary differentially – meaning each elderly person should receive care according to his or her economic, social and health status and receive only according to their needs? The third is, should we provide assistance to the elderly directly (e.g. specific medications) or should the elderly receive financial assistance equivalent to the value of their needs and should we hope that they purchase the relevant medications, for example, and not something else instead? The fourth dilemma is: should we provide assistance for specific projects or should we work on long-term solutions through legislation to provide care and assistance to the elderly? Fifth, which is also the main questions, is should the services provided be privatized or should the treatment be the responsibility of the state and its institutions?The question of privatization or nationalization is the main focus of this article, and while we do not pretend to offer a firm stance on the issue, the authors offer to shed some light on the basic concepts associated with our aging population and how we as a society might handle these issues from the perspective of comparison between privatization versus nationalization of services rendered. The main focus of this article will be around the issue of the residential arrangements for the elderly: Mainly - should the elderly move into what are typically called “old age homes” or should we allow for “Aging in Place” – an approach that favors allowing the elderly to remain in their own homes for the remainder of their lives. Which is the most favorable solution? This issue also falls under the dilemma of whether or not homes for the aging as one possible solution should be a state-provided service or if “aging in place” will result in the privatization of the services granted to the elderly.The focus of this article is the situation in Israel, a country in which a significant portion of the population is elderly and where, by 2035, 15% of the population will be considered senior citizens. We will present the dilemma through the lens of the situation in Israel. The article shall begin with an introduction offering an in-depth examination of the dilemma presented. We will continue by presenting basic concepts from the general literature in the field of gerontology available today. We will then examine the situation in Israel between the years 2017-2019 and conclude by examining the concepts of privatization and nationalization in regards to services for the elderly, while once again emphasizing that comprehensive solutions to these dilemmas are unlikely to be reached in the near future.

The Geriatric Patient

2019 ◽  
Author(s):  
Maggie Mechlin ◽  
Peter Arrabal
Keyword(s):  
Risk Stratification ◽  
Elderly Population ◽  
Geriatric Patients ◽  
The Elderly ◽  
Medical Procedures ◽  
Compassionate Care ◽  
Code Status ◽  
Cognitive Evaluation ◽  
Organ Systems ◽  
Postoperative Cognitive Decline

An aging population combined with the increasing availability of invasive medical procedures has created a growing number of elderly patients that anesthesiologists care for every day. Geriatric patients present unique challenges that must be taken into consideration when crafting an anesthetic plan. To start with, one must first decide what it means to be elderly. Is it an age cutoff? If so, at what age does a patient become elderly? Is it a physiologic definition? If so, what amount of physiologic derangement must be present and in how many organ systems for someone to be classified as elderly? Although there is no clear consensus, a reasonable definition would combine age with the patient’s physical tolerance towards the stresses of surgery. This chapter attempts to address the myriad challenges faced by the perioperative physician who is planning to anesthetize an elderly patient. There are unique points to be noted in the preoperative physical examination, cognitive evaluation, creation of the anesthetic plan, and risk stratification. There are additional concerns related to a patient’s wishes regarding code status and potential end-of-life care. By addressing all these issues, anesthesiologists can provide safe, successful, and compassionate care to a complex and diverse elderly population. This review contains 5 figures, 3 tables, and 52 references. Key Words: anesthetizing the elderly, code status discussion, delirium, pharmacokinetic changes of aging, postoperative cognitive decline, physiologic changes of aging, regional anesthesia for orthopedic surgery, risk stratification

Sign in / Sign up

Export Citation Format

Share Document