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multimorbidity among elderly

Zhi Li, Yi-Pu Zhao, Xiu-Ying Hu
BACKGROUND: The prevalence of hypertension increases with aging. Medication non-adherence is an important reason for the failure to control hypertension effectively, which increases the risks of cardiovascular and cerebrovascular incidents and of mortality. Multimorbidity is common among the elderly and has become a WHO-supported priority of research worldwide. While recent research suggests an association between multimorbidity and medication non-adherence, the results are not yet conclusive...
October 2016: Hu Li za Zhi the Journal of Nursing
Benjamin Marent, Christina C Wieczorek, Karl Krajic
Following the trend in most developed countries, in Austria the oldest old are the fastest growing population group. Among this group, there is a high prevalence of multimorbidity, functional impairment, dementia and psychiatric conditions. While health promotion (HP) has been considered relevant in coping with the challenges of an aging population, it has so far been viewed as a foreign concept in relation to the oldest old, especially those living in residential aged care (RAC) facilities. Although there is an acknowledgement that HP should be integrated into routine nursing, there has been little research on how professionals working with RAC interpret and implement HP...
September 30, 2016: Health Promotion International
Annemarie de Vos, Jane-Murray Cramm, Jeroen D H van Wijngaarden, Ton J E M Bakker, Johan P Mackenbach, Anna P Nieboer
BACKGROUND: The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital-related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2-0.6]), lower depression (Geriatric Depression Scale 15; -0...
September 29, 2016: International Journal of Health Planning and Management
Sabine Lechner, Wolfgang Herzog, Friederike Boehlen, Imad Maatouk, Kai-Uwe Saum, Hermann Brenner, Beate Wild
OBJECTIVE: Older adults appear to be a specifically vulnerable group that could benefit considerably from the assessment of their decision-making preferences. The aim of this study was to estimate prevalence rates and to explore characteristics of control preferences in a population-based sample of older adults. METHODS: Data was derived from the 8-year follow-up of the ESTHER study - a German epidemiological study in the elderly population. n=3124 participants ages 57 to 84 were visited at home by trained medical doctors for a comprehensive assessment regarding various aspects of their life...
July 2016: Journal of Psychosomatic Research
Joanna Bieniek, Krzysztof Wilczyński, Jan Szewieczek
BACKGROUND: Management of geriatric patients would be simplified if a universally accepted definition of frailty for clinical use was defined. Among definitions of frailty, Fried frailty phenotype criteria constitute a common reference frame for many geriatric studies. However, this reference frame has been tested primarily in elderly patients presenting with relatively good health status. OBJECTIVE: The aim of this article was to assess the usefulness and limitations of Fried frailty phenotype criteria in geriatric inpatients, characterized by comorbidity and functional impairments, and to estimate the frailty phenotype prevalence in this group...
2016: Clinical Interventions in Aging
C Cenci
Healthcare organisations, medical knowledge and clinical practice are among the contexts that have most strongly felt the impact of the over 75 population. This is a population of multimorbidity and polypharmacy patients. They are often seen as a conglomeration of juxtaposed guidelines resulting in the intake of more than 10 drugs a day, with absolutely no certainty of their efficacy. The scientific community is increasingly calling into question the current disease-focused approach. Narrative medicine can provide the tools for a treatment plan which is instead more patient-centred...
July 2016: European Journal of Internal Medicine
Marlies E Kerkenaar, Rob J van Marum, Tom Sprong, J E M Janet Bootsma
The incidence of spondylodiscitis is highest among the elderly. Because of the ageing population the incidence of spondylodiscitis is rising. In this article, we illustrate dilemmas which may occur when treating older patients with spondylodiscitis by presenting two cases. The first patient is a 74-year-old man in whom there was uncertainty about the diagnosis on the basis of imaging results. The second patient is an 82-year-old man with dementia in whom longstanding intravenous treatment was too burdensome and treatment with oral antibiotics was started...
2016: Nederlands Tijdschrift Voor Geneeskunde
Louisa Picco, Evanthia Achilla, Edimansyah Abdin, Siow Ann Chong, Janhavi Ajit Vaingankar, Paul McCrone, Hong Choon Chua, Derrick Heng, Harish Magadi, Li Ling Ng, Martin Prince, Mythily Subramaniam
BACKGROUND: Multimorbidity is not uncommon and the associated impact it places on healthcare utilisation and societal costs is of increased concern. The aim of the current study was to estimate the economic burden of multimorbidity among older adults in Singapore by investigating its association with the healthcare and societal resource use and cost. METHODS: The Well-being of the Singapore Elderly (WiSE) study was a single phase, cross sectional survey among a nationally representative sample of Singapore residents (N = 2565) aged 60 years and above...
2016: BMC Health Services Research
Hendrik van den Bussche, Hanna Kaduszkiewicz, Ingmar Schäfer, Daniela Koller, Heike Hansen, Martin Scherer, Gerhard Schön
BACKGROUND: By definition, high utilizers receive a large proportion of medical services and produce relatively high costs. The authors report the results of a study on the utilization of ambulatory medical care by the elderly population in Germany in comparison to other OECD countries. Evidence points to an excessive utilization in Germany. It is important to document these utilization figures and compare them to those in other countries since the healthcare system in Germany stopped recording ambulatory healthcare utilization figures in 2008...
2016: BMC Health Services Research
F Hanke, M Plum, A Wiedemann
In Germany, too, adverse drug events (ADEs) have been identified as a central problem in the care of geriatric patients. Especially in elderly patients with multimorbidity and increasing frailty, ADEs are among the most frequent and cost-intensive causes of illness in healthcare. In most cases, they are due to drug-related diseases, which necessitate enhanced risk awareness and improved cooperation between physicians, medical specialists, geriatric nurses and pharmacists. In this context, the use of urologic medication for geriatric patients requires particular attention by the consultant...
February 2016: Aktuelle Urologie
Åke Grundberg, Anna Hansson, Dorota Religa, Pernilla Hillerås
INTRODUCTION: Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients' mental health status. AIM: To describe HCAs' perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity...
2016: Journal of Multidisciplinary Healthcare
K F Becher
The prevalence and the incidence of Urinary Incontinence is growing. Women suffer predominantly from stress and mixed urinary incontinence and men from urge incontinence. In elderly people, the pathophysiological and the physiological change in the lower urinary tract system must be considered as well as an underlying multimorbidity. Stress urinary incontinence is among others caused by an insufficient urethral closure mechanism and urge incontinence is followed by unhibited detrusor contractions. Medical treatment is beside other important conservative options only one part of the treatment strategy in incontinence...
April 2016: Der Internist
Etienne Duim, Felipe Henrique Cardoso de Sá, Yeda Aparecida de Oliveira Duarte, Rita de Cassia Burgos de Oliveira, Maria Lucia Lebrão
Objective To describe the profile and the characteristics of elderly people with mobility restrictions who are residents in the community and have skin lesions. Method This was an exploratory and descriptive study that was part of the Health, Welfare and Ageing (SABE) study which assessed the presence of skin lesions in a probabilistic sample of elderly people living in the city of São Paulo in relation to factors such as socio-demographic issues, blood biomarkers, health conditions and the use of services...
February 2015: Revista da Escola de Enfermagem da U S P
Davorka Vrdoljak, Josip Anđelo Borovac
UNLABELLED: The aim of this study was to integrate and present pertinent findings from the literature dealing with the treatment of the elderly within a primary care setting. Medical care for the elderly is an integral part of a general practitioner's (GPs) everyday work and is challenging for many reasons. Older people often experience multiple chronic diseases concurrently (comorbidity, multimorbidity) and they often have deteriorated organ function and decreased physiological reserves due to the natural aging process...
2015: Acta Medica Academica
Luca Pasina, Alessandra Marengoni, Simona Ghibelli, Flavio Suardi, Codjo D Djade, Alessandro Nobili, Carlotta Franchi, Gianbattista Guerrini
BACKGROUND: Older nursing home residents often have a large number of diseases and frequently require multiple medications; the high consumption of psychotropic drugs is of particular concern. The majority of residents in nursing homes suffer from dementia, and the use of psychotropic drugs in these patients is very high. Prescription for short periods of time only are usually recommended to avoid the risk of adverse drug reactions and potentially severe drug-drug interactions (DDIs)...
February 2016: Drugs & Aging
Andrea Ticinesi, Antonio Nouvenne, Giuseppina Folesani, Beatrice Prati, Ilaria Morelli, Loredana Guida, Fulvio Lauretani, Marcello Maggio, Tiziana Meschi
OBJECTIVES: To investigate the association of different chronic comorbidities, considered singularly and together in Cumulative Illness Rating Scale (CIRS) indexes, with pneumonia diagnosis in a group of elderly frail hospitalized patients. DESIGN AND METHODS: With a retrospective cohort design, all clinical records of frail (Rockwood ≥ 5) nonterminal patients ≥ 65 years old acutely admitted over a 8-month span in an internal medicine ward were evaluated. Pneumonia status and its categorization (community-acquired, CAP, vs healthcare-associated, HCAP) were defined according to chest radiology findings and validated criteria...
March 2016: European Journal of Internal Medicine
Mariana Mapelli de Paiva, Darlene Mara dos Santos Tavares
OBJECTIVE: to verify the prevalence and associated factors to physical and psychological violence against elderlies and trace the sociodemographic and clinical indicators of this population. METHOD: household survey conducted in 729 elderlies Uberaba - MG. Data were analyzed by Chi-square test and logistic regression (p < 0,05). RESULTS: the prevalence of elderly on violence was 20.9%, and 5.9% to 20.9% for physical and psychological. Among them prevailed women; with 60├80 years; no education; with income, with their partner as the primary aggressor; negative self-perception of health, hospitalization in the last year and presence of multimorbidities...
November 2015: Revista Brasileira de Enfermagem
Bruno Pereira Nunes, Elaine Thumé, Luiz Augusto Facchini
BACKGROUND: Multimorbidity is a public health problem with high prevalence and important consequences. The aim of this paper was to verify the prevalence and distribution of multimorbidity in Brazilian older adults. METHODS: A population-based survey was carried out in 2008 through face-to-face interviews with 1593 older adults (aged 60 or over) living in Bagé, a medium-sized city in Southern Brazil. Multimorbidity was evaluated by 17 morbidities and operationalized according to two cutoff points: 2 or more and 3 or more morbidities...
2015: BMC Public Health
Andrea Budnick, Ronny Kuhnert, Franziska Könner, Sonja Kalinowski, Reinhold Kreutz, Dagmar Dräger
UNLABELLED: The Brief Pain Inventory (BPI) has been psychometrically evaluated worldwide in adult patients with cancer-related and chronic pain in several languages, but never in nursing home residents with chronic pain. To address this gap, we evaluated the validity of a modified version of the BPI, the BPI for nursing home residents (BPI-NHR) in individuals who resided in German nursing homes. One analytic sample included 137 nursing home residents (mean age, 83.3 years; SD, 8.0 years) without any missing values...
February 2016: Journal of Pain: Official Journal of the American Pain Society
Jonathan Mwangi, Asli Kulane, Le Van Hoi
BACKGROUND: Globally, the population of elderly persons is increasing as well as the prevalence of chronic diseases. This change is causing increased healthcare costs to health care systems threatening to push many households into poverty. Low and middle income countries are projected to experience the greatest impact from this change. This study aims to describe the prevalence of common chronic diseases (CCDs) among the elderly in Vietnam, the associated socio-demographic factors and healthcare expenditures...
2015: International Journal for Equity in Health
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