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Polypharmacy in elderly patients with dementia and its effect on recurrent hospital admission 老年痴呆症患者的多重用药及其对反复入院的影响
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325910
Yasmin Bahgat, Aya Mostafa Sayed, Rania El Akkad, Shereen Moustafa Moussa
Background: Dementia is an irreversible neurodegenerative disease characterized by a group of symptoms and signs, including memory impairment, language disturbance, and psychiatric changes, and impairments in activities of daily living. People with dementia had higher levels of comorbidities and may receive more medications(polypharmacy) than their cognitively intact counterparts. Polypharmacy has been linked to an increased risk of negative health outcomes in elderly; including adverse effects, hospitalizations, frailty, and even mortality. Objective: To detect the prevalence of polypharmacy use in demented elderly patients and its effect on recurrent hospital admission from February 2022 to December 2022 at Ain Shams university hospitals. Methods: A cross-sectional study was conducted to detect the prevalence of polypharmacy use in demented elderly patients and its effect on recurrent hospital admission in outpatient clinics of Ain shams university hospital from February 2022 to December 2022.The current study included 90 demented elderly patients who were interviewed to know their personal history, degree of dementia, drug history, medical history, and number of hospital admission in the last year. Results: Prevalence of polypharmacy in our study was 54.4 %. Most of them had minor polypharmacy (38.9 %) who received 4 – 6 medications, and 15.6% of them had severe polypharmacy who received ≥ 7 medications. Our study also showed that 81.1 % of elderly demented patients was admitted to the hospital in the last year, but there was no significant relationship between polypharmacy and recurrent hospital admission. Conclusion: The prevalence of polypharmacy is high among elderly demented patients. Interventions aimed at reducing the prevalence of polypharmacy should be considered. 81.1 % of elderly demented patients was admitted to the hospital in the last year, but there was no significant relationship between polypharmacy and recurrent hospital admission.
背景:痴呆症是一种不可逆的神经退行性疾病,以一系列症状和体征为特征,包括记忆障碍、语言障碍、精神变化和日常生活活动障碍。与认知能力正常的患者相比,痴呆症患者合并症较多,可能需要接受更多的药物治疗(多药治疗)。多药治疗与老年人不良健康后果风险增加有关,包括不良反应、住院、虚弱甚至死亡。研究目的检测艾因夏姆斯大学医院 2022 年 2 月至 2022 年 12 月期间老年痴呆症患者使用多种药物的情况及其对反复入院的影响。研究方法本研究纳入了 90 名老年痴呆症患者,对他们进行了访谈,以了解他们的个人病史、痴呆程度、用药史、病史以及去年的入院次数。研究结果在我们的研究中,使用多种药物的比例为 54.4%。他们中的大多数人(38.9%)有轻微的多药现象,服用 4-6 种药物,15.6% 的人有严重的多药现象,服用的药物≥ 7 种。我们的研究还显示,81.1%的老年痴呆症患者在过去一年中曾入院治疗,但多种药物治疗与反复入院治疗之间没有显著关系。结论在老年痴呆症患者中,使用多种药物的比例很高。应考虑采取干预措施,降低多重用药的发生率。81.1%的老年痴呆症患者去年曾入院治疗,但多重用药与反复入院之间没有显著关系。
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引用次数: 0
Predictors of Hospital Length of Stay among Hospitalized Older Patients with COVID-19 患有 COVID-19 的住院老年患者住院时间的预测因素
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325915
Abdelrahman Hassan Noureldin, Mohamad Ahmad El Sadany, Ahmed M. Osman, Walaa Gad, Sally Maher Adly, Samia Ahmed Abdul-Rahman
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引用次数: 0
Caregivers’ Perspectives Towards Goals of Care and End-of-Life Issues in Egyptian Elderly with Dementia Attending Geriatric Hospital 在老年病医院就诊的埃及老年痴呆症患者中,护理人员对护理目标和临终问题的看法
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325918
NMarwa Abdel Azeem Abdel Gawad, Nourhan Samy Atta, Sally Adel Hakim, Shereen Moustafa Moussa, Heba Youssif Kamel
Background : Pre-discussion of goals of care specially at end of life in dementia is not a common practice in Egypt. Aim : The aim of the current study is to determine caregivers’ perspectives towards goals of care and end of life issues in moderate to severe and severe dementia patients. Methods: A questionnaire was applied on 101 caregivers about perspectives of caregivers of moderate to severe and severe dementia patients toward goals of care and end of life issues. Results: No one of caregivers had previous training for dementia care or discussed dementia care goals or end of life issues with healthcare providers. Perspectives towards goals of care was 60.4% preferred decreasing patient suffering, 39.6% preferred preserving patient function. No one chose life prolongation as a goal of care. Regarding end of life care, 98% of caregivers accepted mechanical ventilation, 90.1% accepted using pain killers, 74.3% accepted using feeding tube and 97% accepted CPR at late stage. There was significant relation between duration since dementia was diagnosed (>1 year) and choosing nursing home for sleep problems and feeding problems. Conclusions: Egyptians caregivers’ perspectives towards goals of care and end of life issues chose to decrease suffering of patients and improve their quality of life rather than prolonging their life span in late stages of dementia. Educational level and caregivers’ relation with the patients didn’t influence caregivers’ perspectives towards end of life issues yet it slightly affected goals of care .
背景:在埃及,预先讨论痴呆症患者生命末期的护理目标并不常见。目的:本研究旨在确定护理人员对中重度和重度痴呆症患者护理目标和生命终结问题的看法。研究方法对 101 名护理人员进行问卷调查,了解中重度和重度痴呆症患者的护理人员对护理目标和生命终结问题的看法。结果所有护理人员都未接受过痴呆症护理培训,也未与医疗服务提供者讨论过痴呆症护理目标或生命终结问题。对护理目标的看法是,60.4%的护理人员倾向于减少患者的痛苦,39.6%的护理人员倾向于保持患者的功能。没有人选择延长生命作为护理目标。关于生命末期护理,98% 的护理人员接受机械通气,90.1% 接受使用止痛药,74.3% 接受使用喂食管,97% 接受晚期心肺复苏。痴呆症确诊时间(>1 年)与因睡眠问题和喂养问题而选择护理院之间存在明显关系。结论埃及护理人员对护理目标和生命末期问题的看法是,在痴呆症晚期选择减少患者的痛苦和提高他们的生活质量,而不是延长他们的寿命。教育水平和护理人员与患者的关系并不影响护理人员对生命末期问题的看法,但对护理目标略有影响。
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引用次数: 0
Relation between socio-demographic data and lifestyle changes during COVID-19 pandemic social confinement in a group of Egyptian elderly 一组埃及老年人在 COVID-19 大流行病社会隔离期间的社会人口数据与生活方式变化之间的关系
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325912
Asmaa Mohamed Mokhtar, Marwa Abd Elazeem Abd Elgawad, Hoda Farid Wahba, Sally Adel Hakim, Somaia Mohamed Ebeid
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引用次数: 0
Relation between Hemodialysis and Oxidative Stress Markers’ blood levels in End Stage Renal Disease on Regular Dialysis 血液透析与定期透析的终末期肾病患者血液中氧化应激标记物水平的关系
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325920
Menna Hossam Arafat, Mennatallah Safwat Elaraby, Tamer Wahid Elsaid, Mohamad Ahmad Alsadany, Mohamed Shawky khater
Background: Chronic kidney disease (CKD) is a common medical problem in elderly. The progressive worsening of renal function in CKD induces numerous biological and clinical dysfunctions including augmentation of synthesis of inflammation and oxidative stress mediators. Aim of the Work: The aim was to study relation between frequency of hemodialysis and oxidative stress markers’ blood levels in end stage renal disease (ESRD) patients on regular dialysis. Patients and Methods: This is a cross-sectional study that was done on a convenience sample of 80 cases of elderly patients,60years and older, who had ESRD and on regular dialysis. The study was conducted in the hemodialysis unit at Ain Shams University Hospital (El-Demerdash).The study period was from the first of May 2021to the end ofNovember2021. Results: We found a statistically significant positive correlation between hemodialysis related factors, namely duration of hemodialysis, number of sessions, and duration of each session and the blood levels of oxidative stress markers. Conclusion: Patients with ESRD on regular hemodialysis are at increased risk of oxidative stress risks as they are shown to have higher oxidative stress biological markers which are directly related to duration of being on hemodialysis, number of hemodialysis sessions and the duration of each session.
背景:慢性肾脏病(CKD)是老年人常见的疾病。慢性肾脏病患者的肾功能逐渐恶化,诱发多种生物和临床功能障碍,包括炎症和氧化应激介质合成增加。工作目的目的是研究定期透析的终末期肾病(ESRD)患者血液透析频率与血液中氧化应激标记物水平之间的关系。患者和方法:这是一项横断面研究,研究对象是 80 例 60 岁及以上定期透析的终末期肾病老年患者。研究在艾因夏姆斯大学医院(El-Demerdash)的血液透析室进行。研究时间为 2021 年 5 月 1 日至 2021 年 11 月底。研究结果我们发现血液透析相关因素(即血液透析持续时间、透析次数和每次透析持续时间)与血液中氧化应激标记物水平之间存在统计学意义上的正相关。结论定期接受血液透析的 ESRD 患者氧化应激风险增加,因为他们的氧化应激生物标志物水平较高,而氧化应激生物标志物与血液透析持续时间、血液透析次数和每次透析持续时间直接相关。
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引用次数: 0
Prevalence and clinical impact of neurocognitive symptoms in geriatric patients with COVID-19. COVID-19 老年患者神经认知症状的发生率和临床影响。
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325913
Mahmoud Mohamed Lotfy, Khalid Elsayed Elsorady, Samia Ahmed Abdul-Rahman, Mohamed Shawky khater
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引用次数: 0
Prognostic Significance of Hematological Parameters in Hospitalized Elderly with COVID-19 COVID-19 住院老人血液学参数的预后意义
Pub Date : 2023-10-01 DOI: 10.21608/ejgg.2023.325911
Heba Ahmed, Ekramy Essa, Dalia Diaa Eldin, Shereen Moustafa Moussa, Suzane Mounir Ali
Background/Aim: COVID-19 is a global pandemic; it caused more than 256 million cases, early detection of patients at high risk of mortality is of great importance in saving lives of COVID-19 patients. “In our study” we aimed to utilize the hematological parameters in predicting prognosis and mortality among elderly patients diagnosed with COVID19 infection admitted at Geriatric isolation hospital, Ain Shams University during the period from 26/12/2020 to 20/6/2021. Methods : This is a retrospective cohort study involving elderly patients admitted at Geriatric isolation hospital, Ain Shams University during the period from 26/12/2020 to 20/6/2021.Retrospective evaluation of medical records was used to collect data. The study included patients older than 60 years with proof of SAR-CoV2 by nasopharyngeal swab. Serial complete blood count parameters were reported during admission: hemoglobin (Hb), Total leukocytic count (TLC), Neutrophils (N), lymphocytes (L), platelets (PLT), Red Cell Distribution Width (RDW), Neutrophil/lymphocyte(NLR), platelet/lymphocyte(PLR) ratios were calculated, other hematological parameters as C-reactive protein (CRP) and ferritin were reported. Results : Among 50 hospitalized COVID 19 patients with mean age of 68.5 years, 54% were males. Mortality of those patients has statistically significant association with presence of high NLR, CRP, Ferritin and lymphopenia on admission and the likelihood of patients’ mortality will rise with presence of NLR>12.4, CRP>120mg/L, FERRITIN>493.6mcg/L and Lymphocytes≤0.88 *10 9/ L on admission, however, presence of CRP>120mg/L is an independent factor for mortality in hospitalized elderly with COVID 19. Conclusion : Hematological parameters as (NLR, CRP, Ferritin and lymphopenia) are predictor markers for mortality in hospitalized elderly with COVID-19.
背景/目的:COVID-19 是一种全球性流行病;它导致了超过 2.56 亿例病例,早期发现高死亡风险患者对于挽救 COVID-19 患者的生命至关重要。"我们的研究 "旨在利用血液学参数预测艾因夏姆斯大学老年隔离医院在 2020 年 12 月 26 日至 2021 年 6 月 20 日期间收治的确诊感染 COVID19 的老年患者的预后和死亡率。方法:这是一项回顾性队列研究,涉及艾因夏姆斯大学老年隔离医院在 2020 年 12 月 26 日至 2021 年 6 月 20 日期间收治的老年患者。研究对象包括通过鼻咽拭子证明感染 SAR-CoV2 的 60 岁以上患者。入院时报告了一系列全血细胞计数参数:血红蛋白(Hb)、白细胞总数(TLC)、中性粒细胞(N)、淋巴细胞(L)、血小板(PLT)、红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)比值,并报告了其他血液学参数,如 C 反应蛋白(CRP)和铁蛋白。结果:在 50 名住院的 COVID 19 患者中,男性占 54%,平均年龄为 68.5 岁。入院时NLR>12.4、CRP>120mg/L、铁蛋白>493.6mcg/L和淋巴细胞≤0.88 *10 9/L的患者死亡率与高NLR、高CRP、高铁蛋白和淋巴细胞减少症有显著的统计学关联,但CRP>120mg/L是COVID 19住院老人的一个独立死亡因素。结论:血液学参数(NLR、CRP、铁蛋白和淋巴细胞减少症)是COVID-19住院患者死亡率的预测指标。
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引用次数: 0
Methylprednisolone Effect on the Outcomes of Severe COVID-19 Cases at Ain Shams University Hospitals from 1st of June 2020 to 31st of August 2020 甲强的松龙对2020年6月1日至2020年8月31日艾因沙姆斯大学附属医院新冠肺炎重症病例预后的影响
Pub Date : 2022-10-01 DOI: 10.21608/ejgg.2022.267985
*. Esraa Adel et al.,
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引用次数: 0
The predictive role of red cell distribution width, neutrophil-lymphocyte ratio and platelet lymphocyte ratio on mortality in COVID-19 patients admitted to intensive care units 红细胞分布宽度、中性粒细胞-淋巴细胞比值和血小板淋巴细胞比值对重症监护病房新冠肺炎患者死亡率的预测作用
Pub Date : 2022-10-01 DOI: 10.21608/ejgg.2022.267993
*. Tawfik and Abdel Kader.,
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引用次数: 0
Possible Contribution of Advanced Glycated End Products Level in Motor Dysfunction in The Elderly 晚期糖化终产物水平在老年人运动功能障碍中的可能作用
Pub Date : 2022-10-01 DOI: 10.21608/ejgg.2022.267992
*. Ali Ramadan et al.,
Background: Advanced glycated end products (AGEs) are a heterogeneous group of molecules that were initially discovered at the beginning of the 20th century in the classic Maillard reaction. AGEs have generated interest in the biochemical and medical fields because of their biological effects on humans, particularly aging. Several studies have associated a decline in physical functioning with higher concentrations of AGEs. Objective: This study aimed to investigate the possible contribution of advanced glycated end-products levels in motor dysfunction in the elderly. Material and methods: The study was carried out on 50 older males aged 65 years old and above who presented to the outpatient clinic of the Main University Alexandria Hospital or were admitted to the Geriatric wards, divided into Group I (control) 20 men with normal handgrip strength and normal walking speed (time to walk 3 meters), Group II (cases) 30 men with poor handgrip strength and slow walking speed. Results: CML levels in group II (cases) ranged from 45.79 – to 101. with a mean value (S.D) of 62.72 ± 12. CML among group I (control) ranged from 49.35 – to 85.50 with a mean value (S. D) of 62.33 ± 7.92.CML was insignificantly higher among the cases group (p=0.390). Conclusion: There was no statistically significant difference between the serum levels of CML in group II (cases) and group I (control).
背景:晚期糖基化终产物(AGEs)是20世纪初在经典美拉德反应中发现的一种多相分子群。由于AGEs对人类的生物学影响,特别是对衰老的影响,它在生物化学和医学领域引起了人们的兴趣。几项研究表明,age浓度较高与身体机能下降有关。目的:本研究旨在探讨晚期糖基化终产物水平在老年人运动功能障碍中的可能作用。材料与方法:选取在亚历山大美因大学医院门诊或老年病房就诊的65岁及以上老年男性50例为研究对象,分为ⅰ组(对照组)20例,握力正常、步行速度正常(步行时间为3米);ⅱ组(病例组)30例,握力差、步行速度慢。结果:II组(例)CML水平为45.79 ~ 101。平均标准差为62.72±12。对照组CML为49.35 ~ 85.50,平均s - D为62.33±7.92。病例组CML无显著性增高(p=0.390)。结论:II组(病例)与I组(对照组)血清CML水平差异无统计学意义。
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引用次数: 0
期刊
The Egyptian Journal of Geriatrics and Gerontology
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