scholarly journals Parameters of functional activity in elderly and senile women with polymorbidity and risk of sarcopenia

2021 ◽  
Vol 6 (3) ◽  
pp. 33-37
Author(s):  
Dmitrii P. Kurmaev ◽  
Svetlana V. Bulgakova ◽  
Natalya O. Zakharova
Keyword(s):  
Clinical Practice ◽  
Muscle Weakness ◽  
Functional Activity ◽  
Charlson Comorbidity Index ◽  
Skeletal Muscles ◽  
The Elderly ◽  
Impaired Function ◽  
Risk Of Progression ◽  
Comorbidity Index

Objectives to identify the correlations between the Charlson comorbidity index and the results of functional activity tests as predictors of sarcopenia among elderly and senile women with polymorbidity. Material and methods. The study included 269 elderly and senile women aged from 65 to 84 years, having polypathology. Results. Sarcopenia was detected in 14.63% of the elderly, and in 27.40% of senile women. The Charlson comorbidity index was associated with the risk of progression of frailty, a decrease in basic functional activity, increased muscle weakness and impaired function of skeletal muscles. Conclusion. Dynamometry and functional activity tests can be used in clinical practice to diagnose sarcopenia syndrome in elderly and senile women.

scholarly journals A data-driven medication score predicts 10-year mortality among aging adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Paavo Häppölä ◽  
Aki S. Havulinna ◽  
Tõnis Tasa ◽  
Nina J. Mars ◽  
Markus Perola ◽  
...  
Keyword(s):  
Charlson Comorbidity Index ◽  
The Elderly ◽  
Data Driven ◽  
Mortality Data ◽  
Point Increase ◽  
Medication Score ◽  
Health Differences ◽  
Comorbidity Index ◽  
Aging Adults ◽  
Aging Societies

Abstract Health differences among the elderly and the role of medical treatments are topical issues in aging societies. We demonstrate the use of modern statistical learning methods to develop a data-driven health measure based on 21 years of pharmacy purchase and mortality data of 12,047 aging individuals. The resulting score was validated with 33,616 individuals from two fully independent datasets and it is strongly associated with all-cause mortality (HR 1.18 per point increase in score; 95% CI 1.14–1.22; p = 2.25e−16). When combined with Charlson comorbidity index, individuals with elevated medication score and comorbidity index had over six times higher risk (HR 6.30; 95% CI 3.84–10.3; AUC = 0.802) compared to individuals with a protective score profile. Alone, the medication score performs similarly to the Charlson comorbidity index and is associated with polygenic risk for coronary heart disease and type 2 diabetes.

scholarly journals COMPREHENSIVE ASSESSMENT OF COMBORIDITY IN CLINICAL PRACTICE: METHODICAL APPROACHES AND PRACTICAL USE

2021 ◽  
Vol 2 (16) ◽  
pp. 32-38
Author(s):  
G.Z. Moroz ◽  
I.M. Hidzynska ◽  
T.S. Lasytsia
Keyword(s):  
Clinical Practice ◽  
Coronary Artery ◽  
Medical Records ◽  
Charlson Comorbidity Index ◽  
Clinical Medicine ◽  
Myocardial Revascularization ◽  
State Institution ◽  
Comprehensive Assessment ◽  
Coronary Artery Stenting ◽  
Comorbidity Index

Aim: to evaluate current approaches to the assessment of comorbidity in clinical practice and determine the prevalence of comorbidities in patients with coronary artery disease (CAD) who underwent coronary artery stenting. Material and methods. We performed a retrospective analysis of data from electronic medical records of 150 CAD patients below 75 yrs having undergone myocardial revascularization via percutaneous coronary intervention (coronary artery stenting). All of them were under the monitoring of the cardiologists of the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. Comorbidity assessment was performed via diseases count; we have dealt only with diseases that are included in the Charlson Comorbidity Index (ССІ) and Combined Age Charlson Comorbidity Index (СА-ССІ) calculation proceeding. We used statistical software programs (Statistica v. 6.0) and Microsoft Excel 2007 applications for data analysis. Results. According to data of the medical records the most common comorbidities (among those used to calculate CCI and CA-CCI) in patients with CAD below 75 yrs who underwent coronary artery stenting were cerebrovascular disease (83.3 ± 3.0%), peripheral vascular diseases (42,7±4,0%), type 2 diabetes mellitus, and mild liver diseases (24,0±3,6%). It was found that the number of comorbid diseases in patients having been examined ranged from 2 to 7, with an average of 3,9±0,1. The mean number of diseases in patients of different ages did not differ significantly. The average CA-CCI value increased from 4,4±0,2 points in patients who had two diseases to 12,7±1,1 points in those with seven ones (р<0,05). Conclusions. Our study revealed a high prevalence of comorbidities in patients with CAD below 75 yrs who underwent coronary artery stenting. The use of CA-CCI allowed making a comprehensive assessment of patient’s conditions

Melatonin and the Charlson Comorbidity Index (CCI): The Treviso Longeva (Trelong) Study

2014 ◽  
Vol 29 (3) ◽  
pp. 253-260 ◽  
Author(s):  
Maurizio Gallucci ◽  
Rafael Flores-Obando ◽  
Stefano Mazzuco ◽  
Fausta Ongaro ◽  
Enrico Di Giorgi ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Charlson Comorbidity Index ◽  
Statistical Significance ◽  
Secondary Data ◽  
The Elderly ◽  
Protective Role ◽  
Elderly Subjects ◽  
Enzyme Linked Immunosorbent Assay ◽  
Sample Population ◽  
Comorbidity Index

Introduction It has been reported that elderly subjects have a compromised ability to produce melatonin nightly, and that reduced melatonin levels may be a risk factor for cancer. The purpose of this study was to evaluate the relationship between melatonin levels and chronic diseases in a cohort of elderly subjects using the Charlson comorbidity index (CCI). Design We performed a secondary data analysis of a longitudinal study of a representative, age-stratified, sample population. Setting The Treviso Longeva (Trelong) study, in Treviso, Italy. Participants A total of 114 men and 146 women, aged 77 years and older, still alive after 7 years of follow-up. Measurements As an estimation of serum melatonin secretion levels, urinary 6-sulfatoxymelatonin (aMT6s) was assayed in the urine of 260 elderly subjects using an enzyme-linked immunosorbent assay (ELISA) kit (product 01-EK-M6S, ALPCO Immunoassays, Windham, NH). All aMT6s levels were creatinine standardized ([aMT6s]/[creatinine]), and the CCI was calculated. Results The melatonin levels decreased with aging despite not reaching statistical significance, and the decrease was more evident in males than in females (40.5 ng vs 47.0 ng aMT6s/mg creatinine, ns). Melatonin levels were significantly lower in patients reporting insomnia (p=0.05). The CCI score was inversely correlated with the levels of melatonin (p=0.03). Melatonin levels of subjects affected by CCI pathologies were significantly lower than those of healthy subjects (p=0.03) and of subjects suffering from diseases not included in the CCI and, therefore, less severe (p=0.03). Conclusion Melatonin appears to be a marker of disease state and severity, as well as of sleep disorders, in the elderly. These early findings would confirm the protective role of melatonin against several chronic diseases. The benefits of this agent as a possible medication should be more thoroughly clinically tested.

scholarly journals Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001339
Author(s):  
David Messika-Zeitoun ◽  
Pascal Candolfi ◽  
Maurice Enriquez-Sarano ◽  
Ian G Burwash ◽  
Vincent Chan ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Hospital Mortality ◽  
Charlson Comorbidity Index ◽  
Female Gender ◽  
The Elderly ◽  
Mitral Valve Surgery ◽  
National Database ◽  
Cross Sectional ◽  
Comorbidity Index ◽  
Systèmes D’Information

ObjectivesUnbiased information regarding the surgical management of patients with mitral regurgitation (MR) at the nationwide level are scarce and mainly US-based. The Programme de Médicalisation des Systèmes d’Information, a mandatory national database, offers the unique opportunity to assess the presentation and outcomes of all consecutive mitral valve (MV) surgeries performed in France in the contemporary era.MethodsWe collected all MV surgeries performed for MR in France in 2014–2016. MR aetiology was classified as degenerative (DMR), secondary (SMR) or Other (rheumatic or congenital disease and infective endocarditis).ResultsDuring the 3-year period, 18 167 MV surgeries were performed in France (55% repair and 45% replacement; 52% isolated). Age was 66±12 years and 59% were male. Aetiology was DMR in 42%, SMR in 16% and other in 42% including 19% with uncertain aetiologies. Overall, in-hospital mortality was 6.5% and increased with age, female gender, Charlson Comorbidity Index, type of surgery (replacement vs repair), associated surgery (combined vs isolated) and MR aetiology (all p<0.01). In-hospital mortality and rate of death/readmission for heart failure (HF) at 1 year were 3.4% and 13%, respectively for DMR (2.4% and 11% for isolated DMR) and 7.8% and 27%, respectively for SMR (5.5% and 23% for isolated SMR). Repair rate was 55% overall, 68% in DMR and 72% for isolated DMR surgery (70% of all DMR). Repair rates decreased with age, Charlson Comorbidity Index and female sex (all p<0.0001).ConclusionIn this cross-sectional contemporary prospective nationwide database, in-hospital mortality and 1 year rate of death and HF readmission were considerable overall and in all subsets. Repair rates were suboptimal overall especially in the elderly and women subsets. These results underline the need to develop strategies to improve management and outcomes of patients with both DMR and SMR.

scholarly journals The Charlson comorbidity index (CCI) for adjustment of hip fracture mortality in the elderly: analysis of the importance of recording secondary diagnoses

2008 ◽  
Vol 24 (2) ◽  
pp. 315-322 ◽  
Author(s):  
Rômulo Cristovão de Souza ◽  
Rejane Sobrino Pinheiro ◽  
Cláudia Medina Coeli ◽  
Kenneth Rochel de Camargo Jr.
Keyword(s):  
Hip Fracture ◽  
Mortality Rate ◽  
Risk Adjustment ◽  
Charlson Comorbidity Index ◽  
The Elderly ◽  
Predictive Capacity ◽  
Logistic Regression Models ◽  
Highest Weight ◽  
Comorbidity Index ◽  
Hip Fracture Mortality

This study evaluates the role of the number of secondary diagnoses for calculating the Charlson comorbidity index (CCI) in risk adjustment of the 90-day mortality rate after hip fracture surgical repair. Comorbidities were selected by reviewing the medical records of 390 patients 50 years of age or older in a teaching hospital in Rio de Janeiro from 1995 to 2000. Logistic regression models were fitted including the variables age, sex, and CCI. The CCI was calculated based on: (1) all patients' comorbidities; (2) only the comorbidity with the highest weight; and (3) a single randomly selected comorbidity. There was a gradient in the prediction of the CCI mortality rate when all comorbidities were used (OR = 6.53; 95%CI: 2.27-18.77, for scores <FONT FACE=Symbol>³</FONT> 3). The predictive capacity of the CCI was observed even when it was calculated using only one comorbidity: with the highest weight (OR = 2.83; 95%CI: 1.11-7.22); and randomly selected (OR = 2.90; 95%CI: 1.07-7.81). Using all comorbidities for CCI calculation is important. Severity indices based on a single comorbidity can be useful for risk adjustment procedures.

Prognostic value of Charlson Comorbidity Index in the elderly with a cardioverter defibrillator implantation

2020 ◽  
Vol 314 ◽  
pp. 64-69
Author(s):  
Pierre Poupin ◽  
Claire Bouleti ◽  
Bruno Degand ◽  
Marc Paccalin ◽  
François Le Gal ◽  
...  
Keyword(s):  
Charlson Comorbidity Index ◽  
Prognostic Value ◽  
The Elderly ◽  
Cardioverter Defibrillator ◽  
Comorbidity Index

scholarly journals Treatment of knee joint osteoarthritis in overweight women in outpatient practice

2021 ◽  
Vol 15 (4) ◽  
pp. 63-67
Author(s):  
P. S. Kovalenko ◽  
I. S. Dydykina ◽  
E. S. Aronova ◽  
O. G. Alekseeva ◽  
E. L. Shakhramanova ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Status ◽  
Body Mass ◽  
Charlson Comorbidity Index ◽  
Overweight Women ◽  
Knee Oa ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Limited Function ◽  
Comorbidity Index

Objectives: evaluation of the clinical efficacy and safety of the healthy joints maintaining compound Artroflex® in knee osteoarthritis (OA) in postmenopausal overweight women in outpatient clinical practice.Patients and methods. An open, prospective observational single-center post-marketing study included 30 postmenopausal women 50–75 years old (mean age 62.3±6.3 years) with knee OA. Patient body mass index (BMI) was >25 (mean body weight 85.3±15.3 kg). Radiographically confirmed primary gonarthrosis stage II according to Kellgren–Lawrence was detected in 26 (87.0%) patients, stage III – in 4 (13.0%). The duration of knee OA ranged from 1 to 21 years (average 7.8±6.1 years).Artroflex® was prescribed 1 capsule 2 times a day for 3 months. During three visits (baseline, after 1 and 3 months), the need for analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) and the occurrence of adverse reactions (AR) were determined. Health status and pain level were also assessed using a visual analogue scale (VAS), the severity of pain and stiffness, limited function according to the WOMAC questionnaire, fatigue/fatigue according to the FACIT scale, the Charlson comorbidity index, satisfaction of the doctor with the results of treatment using the IMOS scale, and satisfaction of the patient with using the IMPSS scale.Results and discussion. A statistically significant decrease in the pain score according to the VAS, an improvement in health status, and the WOMAC index were found in the overwhelming number of patients, regardless of BMI. 90% of women noted decrease in fatigue/fatigue on the FACIT scale, and 93% of patients reported satisfaction with treatment, regardless of the Charlson comorbidity index. The need for NSAIDs after one month of use of the Artroflex® compound decreased by 7%, after 3 months – by 23%. A negative feedback was found between the baseline indicator of health status and the assessment of the effectiveness of therapy. No serious ARs were identified during the study.Conclusion. Feasibility of using the Artroflex® compound in real clinical practice in patients with knee OA and excessive body mass has been shown.

scholarly journals Adherence to statin therapy in patients with high and very high cardiovascular risk in real clinical practice

2020 ◽  
Vol 11 (1) ◽  
pp. 38-48
Author(s):  
V. I. Podzolkov ◽  
A. E. Bragina ◽  
L. V. Vasil’eva ◽  
Yu. P. Grintsevich ◽  
Yu. N. Rodionova
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Risk ◽  
Statin Therapy ◽  
Charlson Comorbidity Index ◽  
High Cardiovascular Risk ◽  
Positive Correlation ◽  
Comorbidity Index ◽  
Very High ◽  
Real Clinical Practice

Despite the proven efficacy of lipid-lowering therapy, adherence to long-term statin therapy in patients with cardiovascular disease remains low.Aim. To study adherence to long-term statin therapy and factors associated with adherence in patients with high and very high cardiovascular risk (CVR) in real clinical practice.Materials and methods. The single-center cohort study included 53 patients (mean age 68.1 ± 10.2 years) with high or very high CVR on the SCORE scale and have been taking statins for at least 3 months prior to inclusion in the study. The level of low-density lipoprotein cholesterol (LDL-C), cognitive impairment (MoCA test), anxiety and depression (HADS scale), presence of senile asthenia (FRAIL scale), M. Charlson comorbidity index were assessed. Adherence to statin therapy was assessed using the original questionnaire. The correlation between patient adherence and ordinal variables for the scores of the studied scales was studied.Results. Completely adherent to statin therapy were only 12 (22%) patients, 14 (26%) were insufficiently adherent, 27 (51%) were non-adherent. The target level of LDL-С was achieved in 13 (25%) patients. 38 (72%) patients showed a decrease in cognitive functions; a positive correlation was found between adherence and the MoCA test (r = 0.44, p = 0.04). Clinical and subclinical depression and anxiety were noted in 12 (23%) and 14 (26%) patients, respectively. A statistically significant negative correlation was found between adherence and depression (r = –0.32; p = 0.04) and a positive correlation between adherence and anxiety (r = 0.44; p = 0.04). There was no statistically significant correlation between adherence and the FRAIL fragility scale, as well as the M. Charlson comorbidity index.Conclusions. Depression and cognitive decline are associated with decreased adherence to statin therapy.

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