Arthritis Sufferers Research Articles

Pengaruh Fisioterapi terhadap Penurunan Nyeri pada Pasien Rheumatoid Artritis di Klinik Fisioterapi Kota Jambi

Rheumatoid Arthritis sufferers nationally in Indonesia are dominated by someone who has entered the age of Pre-elderly to the elderly in the age range between 55-64 years (15.5%), 67-74 years (18.6%), and ages above 75 years is at the number (18.9%), when totaled between the pre-elderly age up to 53% suffering from Rheumatoid Arthritis (Riskesdas 2018). Rheumatoid arthritis is a joint disease that occurs due to an autoimmune disorder that causes inflammation of the joints that causes pain, heat, stiffness, weakness. The solution offered to prevent this from happening is to provide physiotherapy to the aching joints. The goal is to reduce pain levels in patients undergoing physiotherapy at a physiotherapy clinic. The research method used in this study is quantitative, with a sample of 60 people, the method used is Pre Experimental Design with Pre Test and Post Test One Group design with intervention given to patients measured at each stage of physiotherapy. Research Results: Most of them are male (53.33%). Most of them are adults and elderly (35%) The description of the patient's pain level before physiotherapy is done, all patients experience pain, most of which are on a moderate to severe scale. After doing physiotherapy on T1 severe pain became 0%, and mild pain was 21.67%, on T2 mild pain was 6.67% and no pain was no pain 13.33%, while T3 was mostly in the no pain category (68.33%). The results of the statistical test obtained a p-value of 0.000. It can be concluded that physiotherapy is very effective in reducing pain levels in patients with pain rheumatoid artritis.

The Effectiveness of Ergonomic Gymnastics Against Changes in Uric Acid Levels

Background: Uric acid is the end product of purine metabolism, where purines are one of the components of nucleic acids found in the nucleus of body cells. Gout attacks the joints of the body and generally attacks the joints of the fingers, heels, toes, elbows, knees, and wrists. One of the treatments for high uric acid levels in the body is ergonomic exercise.
 Objectives: The purpose of this study was to analyze the effectiveness of ergonomic exercise on changes in uric acid levels in the community.
 Methods: The type of research used is Pre-Experimental with One Group Pre-Post Test Design. Sampling using the Non Probability Sampling method with the Consecutive Sampling technique with a sample of 30 respondents. This study provides an intervention for patients with gout arthritis in the form of ergonomic exercise. The implementation of the intervention begins with a Pre-Test (measurement of uric acid levels), then giving an ergonomic exercise intervention for 4 weeks (1x a week with a duration of 30 minutes), then a Post-Test (measurement of uric acid levels) is carried out. The instrument used is a multi-check uric acid measuring instrument, SOP for the implementation of ergonomic exercises, and implementation observation sheets.
 Results: The results of the study were that the majority of the majority age was in the late adult category (36-45 years), the majority sex was in the female sex category of 19 respondents (63.3%), and uric acid levels before being given ergonomic exercise intervention were the majority in the high category. by 28 respondents (93.3%). while the uric acid levels after the ergonomic exercise intervention were mostly in the normal category of 25 respondents (83.3%). The results of the Wilcoxon test analysis were obtained (p = 0.000 = 0.05) where ergonomic exercise was effective in reducing uric acid levels.
 Conclusion: The results of this study indicate that there is a significant effect of ergonomic exercise on reducing people's uric acid levels, so the researchers recommend to the community, especially gout arthritis sufferers, to make ergonomic exercise interventions one of the intervention options that can be done independently, practically and efficiently in reducing levels. gout and the need for attention to the regulation of a healthy lifestyle to prevent more severe complications in the future.

The Effectiveness of Health Education about Gout Arthritis Diet Compliance and Uric Acid Levels in Gout Arthritis Patients

The habit of consuming seafood and also some lifestyle in Minahasa culture contributes to the increase cases of gout arthritis. This is also supported by the lack of knowledge and information about the correct diet for gouty arthritis sufferers. The existence of the right information can help sufferers to implement a healthy diet so that it can reduce uric acid levels. The purpose of this study was to assess the effectiveness of health education on uric acid levels in gouty arthritis sufferers. This study was conducted with a quasi-experimental research design, using one group pretest-posttest approach on 30 gout arthritis patients in Bongkudai Selatan Village, North Sulawesi. The sampling technique used was accidental sampling, and the data were analyzed using univariate and bivariate analysis. The results showed that there was a decrease in uric acid levels in 70% of respondents and there was an effect of health education on uric acid levels with a p value of 0.0325.

DESCRIPTION OF THE RHEUMATOID FACTOR TEST IN WOMEN THE MENOPAUSE TO DETECT RHEUMATOID ARTHRITIS IN ULAPATO-A VILLAGE, GORONTALO DISTRICT


 Based on data from the Gorontalo provincial health office in 2017 the incidence of Rheumatoid Arthritis reached 14,391 the number of cases. Rheumatoid Arthritis is a chronic autoimmune inflammatory system disease whose cause is unknown. Symptoms of Rheumatoid Arthritis include experiencing stiffness in the joints in the morning, and swelling of the joints. This study aims to determine the results of Rheumatoid Arthritis test in menopausal women in Ulapato-A Village, Gorontalo District by examining Rheumatoid Factors.
 This research is a quantitative descriptive study with a total of 34 samples. Using manual Rheumatoid Factor Check. This research was processed through the IBM SPSS Statistics V25.0 program. then presented in tabular form and reported as a percentage using the Frequency Distribution formula.
 From the results obtained, 8 samples (23.5%) were positive while 26 samples (76.5%) were negative. In conclusion Rheumatoid factor in menopausal women is mostly negative. It is hoped that Rheumatoid Arthritis sufferers maintain their health by living a healthy lifestyle and doing light exercise and for other researchers to also carry out semi-quantitative follow-up examinations if they get a positive sample.
 

Application of Nanotubes Combined with Ethnic Sports Rehabilitation Therapy in the Treatment of Patients with Knee Arthritis

National sports are traditional sports of ethnic minorities and sports with strong national characteristics. Sports performances generally include weightlifting, boxing or martial arts, gymnastics, skating, high jump, sprint, and hurdles. Such as knee joints that are particularly vulnerable to injury. Therefore, ordinary ethnic sports athletes are particularly vulnerable to injury. Ethnic sports rehabilitation therapy uses some exercises to enable patients to obtain full or partial exercise functions. Training methods for sensory function recovery were used. Ethnic sports rehabilitation therapy is a common rehabilitation therapy for ethnic sports athletes to resume sports training, such as table tennis, tennis, cycling, fishing, climbing, skating, weightlifting, and wrestling. However, with economic development and social progress, the treatment of knee arthritis is closely integrated with nanotubes combined with national sports rehabilitation therapy, and it has been increasingly used in competitive sports and national fitness. From 2003 to 2020, the medical research literature on nanotechnology increased from 20 to more than 20,000. This article presents a way for treating knee arthritis sufferers by combining nanotubes with ethnic sports rehabilitation therapy and discusses the clinical therapeutic effect of nanotubes combined with ethnic sports rehabilitation therapy in the treatment of knee arthritis patients. It provides a certain basis for the treatment of patients with knee arthritis. This article selected 100 knee patients, who, as research subjects, visited our facility for medical treatment between June 2016 and June 2020, and divided 100 patients into two groups, 50 patients in the experimental group and 50 patients in the control group. For patients, the experimental group used nanotubes combined with ethnic sports rehabilitation therapy to treat patients, and the control group used ethnic sports rehabilitation therapy to treat patients. The experimental results show that nanotubes combined with ethnic sports rehabilitation therapy can speed up the treatment process of patients with knee arthritis. When the experiment lasted only 5 days, patients in the control group scored an average of 3 points, and on the last day, they scored an average of 6.9 points. In the experimental group, the average score of patients on the fifth day of the experiment was 5 points, and the average score of patients on the last day was 9.7 points. The knee joint patients in the experimental group have higher walking ability, up‐and‐down ability, knee flexion, and knee swelling. In the control group, among them, the first to recover from knee arthritis is the ability to walk, and the slowest recovery is the flexion of the knee joint.

The effect of a warm compress of cinnamon on reducing pain in sufferers of arthritis gout

Background: One of the disorders experienced by gout arthritis sufferers is pain in the joints. Joint pain in patients with gouty arthritis occurs due to deposits of monosodiumuric crystals that accumulate in the joints as a result of high levels of gout arthritis in the blood. One of the interventions that can be given to reduce the pain scale in sufferers of gouty arthritis is the administration of warm cinnamon compresses. The essential oil in cinnamon bark contains eugenol, where eugenol has a very hot and spicy taste so it can open the skin's pores. So that pain can be reduced with the warm cinnamon compress.
 Purpose: The effect of the warm cinnamon compress aims to determine the benefits of the warm cinnamon compress to reduce the pain scale in sufferers of gout arthritis.
 Methods: This study used a quasi-experimental method with a pre and post control group approach. The sample in this study amounted to 50 respondents, the sample was taken by stratified random.
 Results: The results of the Wilcoxon test showed that the p value in the control group was 0.850 and the intervention group obtained a p value of 0.000. The results of the Paired T-test showed that the p value in the control group was 0.594 and the intervention group obtained a p value of 0.000. Independent T-test results obtained p value 0.000 <0.05, meaning that there is an effect of warm cinnamon compresses on reducing pain in patients with gout arthritis before and after giving warm cinnamon compresses between the intervention group and the control group.
 Conclusion: The warm cinnamon compress has an effect on reducing the pain scale in people with gouty arthritis.
 Keywords: gout arthritis, pain, cinnamon warm compress

EASILY (Easy to Use Kitchen Utilities) Designing Cutting Boards Sets for Elderly and Arthritis Sufferers with Quality Function Deployment

Based on the Indonesian Population Census in 2015, the number of elderly people aged over 60 years in Indonesia reached 2.1 million people. Elderly women do ADL (Activities Daily Living) is higher than the population of elderly men. One ADL that is still often done by the elderly woman is cooking while the process of manually using a cutting board. The purpose of this research is to developed cutting board set named EASILY (Easy-to-Use Kitchen Utilities) which is a set of cutting tools consisting of ergonomic knife and cutting board that comfortable to use and also it does not need much power from operator to do the cutting activities. The steps taken with the method of Quality Function Deployment, to process and interpreting consumer need for product specifications. Usability test is applied with satisfaction attribute performed to determine the level of user satisfaction through interview when subject using EASILY product. The result of this reserach show that EASILY have 4 components there are Cutting Board, Knife Holder, Food Holder, and Trash Tray. The subject feel comfortable while using EASILY after doing the usability testing. Recommendation for further reserach the product development can be done using another product design method, and the usability testing should using more respondent.

Effect of Elderly Exercise on Pain Scale in Patients with Rheumatoid Arthritis

Rheumatoid arthritis is the most common articular inflammatory disease in the elderly. Rheumatoid arthritis is a chronic, systemic disease that typically develops slowly and is characterized by recurrent inflammation of the diarthrodial joints and associated structures. According to the Ciamis District Office, from the entire Ciamis District Health Center, 17,492 cases of rheumatoid arthritis were diagnosed. To determine the effect of elderly exercise on pain scale in patients with rheumatoid arthritis at the Ciamis Public Health Center. This research method is a pre-experimental design in the form of one group One-Shot Case Study. The population in this study were the elderly aged 45-59 years as many as 129 people. The sampling technique in this research is accidental sampling. The sample in this study were the elderly aged 45-59 years as many as 56 people. The results of the study stated that there was an influence of elderly exercise on the pain scale in patients with rheumatoid arthritis at the Ciamis Health Center, with the significance value of the Wilcoxon test results showing (P = 0.029 <0.05). This means that rheumatoid arthritis can be reduced by doing sports, one of which is by doing elderly gymnastics. Exercise that is done regularly can strengthen the muscles around the joints, reduce pain or aches, improve balance and provide more energy in the body. Conclusion is elderly exercise can affect the pain scale of rheumatoid arthritis sufferers

Predicting treatment course and outcome using a promotion and prevention framework in a community sample of arthritis sufferers.

ObjectiveThe present study examined the proposition that patients need to focus on something beyond simply “getting better”. In a sample of arthritis sufferers, we distinguished individuals by the goals that motivated them – moving toward aspirational goals and maximizing gains (promotion focus) rather than obligations and minimizing losses (prevention focus) – and how these motivational styles influenced treatment.MethodsPatients (N=254) participated in a randomized controlled trial of resistance training and self-management, providing 6 time points of data over 2 years. Promotion and prevention focus at baseline were used to predict the course (compliance and changes in coping self-efficacy) and outcome (changes in physical functioning) of treatment.ResultsArthritis sufferers with strong promotion orientations showed significant improvements in physical functioning (a direct positive impact on physical health); there were no significant associations with treatment compliance and coping self-efficacy. Arthritis sufferers with strong prevention orientations complied less with the treatment and showed little change in coping self-efficacy during treatment, which, in turn, predicted worse physical functioning over time (a pernicious, indirect influence on treatment outcome).ConclusionA focus on positive approach-oriented goals may improve overall treatment response, whereas a focus on negative avoidance-oriented goals may degrade treatment response through reduced compliance and self-efficacy.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN ARTHRITIS RHEUMOTOID PADA LANSIA DEWASA MUDA DI WILAYAH KERJA PUSKESMAS RATU AGUNG KOTA BENGKULU

Arthritis RheumotoidCases in Bengkulu City in 2016 that arthritis sufferers occupy all 5 levels similar to Athritis Rheumotoid with 7.889 inhabitants. This study aimed to determine the factors associated with the occurrence of Arthritis Rheumotoid at Ratu Agung Health Center in the city.Thesamples of this study were taken by using an accidental sampling, 69 young adult elderly visiting the health center. The data were collected through direct interview techniques using a questionnaire. The data analysis was done using Univariate and Bivariate analysis with chi-square test at α 5%.The results showed that most of the elderly knowledge 49 (71.0%) were sufficient, the majority of the elderly 38 people (55.0%)were female, and almost half of the elderly 30 (43.4%) had medium activity, mostly that no genetically by 37 elderly (54.0%).Most elderly young adults of 39 elderly (56.5%), almost half of the elderly who did not have Arthrtitis Rheumotoid 30 elderly people (43.5%). From the results of the chi-square p = 0.017, 0.031, 0.017, 0.002, and 0.002. Showed no relationship between knowledge, sex, activity, genetic events on the elderly with Arthritis Rheumotoid at Ratu Agung Health Center in the city.The health center is expected to increase to provide more information about Arthritis Rheumotoid in improving the health status of the elderly young adults.

Hand deformities in Filippino Lippi's Magrini Altarpiece (c. 1482).

Examination of the four saints in Filippino Lippi's Magrini Altarpiece (c. 1482) shows that they all have hand deformities of various kinds. The two saints on the viewer's left, St Rocco and St Sebastian, are portrayed as young, aristocratic men. Those on the viewer's right, St Jerome and St Helena, are depicted as a much older man and a young woman, respectively. It is of interest that the two young men have more significant deformities, while the older man and the young woman are less severely affected. The realism of the depiction of the young men's hands makes it probable that the artist deliberately chose models with arthritic deformities or else painted the hands from memory after having observed other arthritis sufferers. As a more speculative concluding note, it is also suggested, on the basis of comparisons with other paintings from the same period, that the artist may have chosen to depict the young male saints' hands in this way to emphasise both their aristocratic standing and the role of suffering and martyrdom in their traditional biographies.

A critical review of complementary and alternative medicine use among people with arthritis: a focus upon prevalence, cost, user profiles, motivation, decision-making, perceived benefits and communication.

A critical review of complementary and alternative medicine (CAM) use among people with arthritis was conducted focusing upon prevalence and profile of CAM users as well as their motivation, decision-making, perceived benefits and communication with healthcare providers. A comprehensive search of peer-reviewed literature published from 2008 to 2015 was undertaken via CINAHL, Medline and AMED databases. The initial search identified 4331 articles, of which 49 articles met selection criteria. The review shows a high prevalence of CAM use (often multiple types and concurrent to conventional medical care) among those with arthritis which is not restricted to any particular geographic or social-economic status. A large proportion of arthritis sufferers using CAM consider these medicines to be somewhat or very effective but almost half do not inform their healthcare provider about their CAM use. It is suggested that rheumatologists and others providing health care for patients with arthritis should be cognizant of the high prevalence of CAM use and the challenges associated with possible concurrent use of CAM and conventional medicine among their patients.

Drug breakthrough offers hope to arthritis sufferers: qualitative analysis of medical research in UK newspapers.

BackgroundNewspaper stories can impact behaviours, particularly in relation to research participation. It is therefore important to understand the narratives presented and ways in which these are received. Some work to date assumes journalism transmits existing medical knowledge to a passive audience. This study aimed to explore how newspaper articles present stories about medical research and how people interpret and use them.DesignQualitative research methods were employed to analyse two data sets: newspaper articles relating to ‘rheumatoid arthritis’ and ‘research’ from UK local and national news sources; and existing transcripts of interviews with patients with rheumatoid arthritis and their carers.ResultsNewspapers present a positive account of medical research, through a simple narrative with three essential components: an ‘innovation’ offers ‘hope’ in the context of ‘burden’. Patients frequently feature as passive subjects without attributed opinions. Few articles include patients’ experiences of research involvement. Patients with rheumatoid arthritis and their carers read articles about medical research critically, often with cynicism and drawing on other sources for interpretation.ConclusionsAn understanding of the simple, positive narrative of medical research found in newspaper articles may enable researchers to gain mass media exposure for their work and challenge this typical style of reporting. The critical and cynical ways patients and carers read stories about medical research suggest that concerns about newspaper articles misinforming the public may be overstated, but any effect on research engagement is unknown. Newspaper articles rarely present patients’ views or their experiences of research, and this can be conceptualized as ‘depersonalization bias’.

A Universally Designed and Usable Data Visualization for A Mobile Application in the Context of Rheumatoid Arthritis

This paper discusses the design, development and evaluation of a data visualization prototype for a mobile application, for people with rheumatoid arthritis conditions. The visualizations concern ways of displaying graphically data for monitoring and evaluating the daily activities of rheumatoid arthritis sufferers. An initial visualization was developed and then a second was developed, aiming to be more usable and universally designed than the first version. An empirical experiment was used for evaluation and collection of quantitative data. Furthermore, semi-structured interviews were used for eliciting more qualitative data in terms of participant opinions. The overall results suggest that the second visualization was more usable and more universally designed than the first version. The paper concludes with some recommendations for future improvements.

Joint mobility and inclusive design challenges

The aim of this research study was to understand and evaluate the effect of different factors including age, gender, disabilities and medical conditions on joint mobility. Joint mobility data from a group of 66 people from a previously existing database has been re-analysed. Twenty four participants had disabilities and 42 participants were considered to be ‘able bodied’ with no recognised disability. For each individual, 18 joint range of motion values were measured and an ANOVA test was employed to demonstrate the influence of the selected factors on joint range of motion. Post Hoc (Tukey) tests were also performed to gain deeper insight into significance levels and correlations between the factors. The results clearly indicate that joint ROM significantly decreases (p < 0.05) with increasing age for arm abduction, arm medial and lateral rotation, wrist flexion and wrist adduction. Moreover, people with disabilities (wheelchair users and arthritis sufferers) showed a considerable decrease in joint mobility for arm flexion, arm abduction, arm lateral rotation, elbow flexion, elbow supination, wrist extension and wrist flexion. The results also highlight that designing products, equipment, services or workplaces against 5th and 95th percentile criteria is unable to provide appropriate and necessary support for achieving the objective of design inclusiveness. Rather designers should have a deep insight of the data variations at a predesign phase so that more appropriate and informed design decisions can be made that are more likely to be acceptable for a broad range of the population.

A Natural Cure to Arthritis by Phytomedicines-A Review

Arthritis is one of the major problems in older age. There are about as many herbal remedies for arthritis as there are arthritis sufferers. Most work by improving the circulation, and encourage fluid elimination. Inflammation due arthritis is mediated through many primary and secondary mediators. Interleukins and TNF-α are one of these mediators. Anti-inflammatory agents are used in arthritis widely. A large flora of herbal medicines is available in traditional medicine and basic scientific research has provided an understanding of the efficacy of these remedies in treating arthritis. In recent years, there has been boom in research and industries focusing on herbal remedies to treat a variety of diseases including arthritis. Several developments in clinical studies in carefully designed clinical trials have made the way easier to include herbs as arthritis therapy. This review is focused on the potential role of herbs in treating arthritis and prospects for the future.

Injection of modified cells reduces inflammation in arthritis sufferers

Injection of modified cells reduces inflammation in arthritis sufferers

Current and emerging therapeutic strategies for preventing inflammation and aggrecanase-mediated cartilage destruction in arthritis.

Arthritis is a multifactorial disease for which current therapeutic intervention with high efficacy remains challenging. Arthritis predominately affects articular joints, and cartilage deterioration and inflammation are key characteristics. Current therapeutics targeting inflammatory responses often cause severe side effects in patients because of the systemic inhibition of cytokines or other global immunosuppressive activities. Furthermore, a lack of primary response or failure to sustain a response to treatment through acquired drug resistance is an ongoing concern. Nevertheless, treatments such as disease-modifying anti-rheumatic drugs, biological agents, and corticosteroids have revealed promising outcomes by decreasing pain and inflammation in patients and in some cases reducing radiographic progression of the disease. Emerging and anecdotal therapeutics with anti-inflammatory activity, alongside specific inhibitors of the A Disintegrin-like And Metalloproteinase domain with Thrombospondin-1 repeats (ADAMTS) cartilage-degrading aggrecanases, provide promising additions to current arthritis treatment strategies. Thus, it is paramount that treatment strategies be optimized to increase efficacy, reduce debilitating side effects, and improve the quality of life of patients with arthritis. Here, we review the current strategies that attempt to slow or halt the progression of osteoarthritis and rheumatoid arthritis, providing an up-to-date summary of pharmaceutical treatment strategies and side effects. Importantly, we highlight their potential to indirectly regulate ADAMTS aggrecanase activity through their targeting of inflammatory mediators, thus providing insight into a mechanism by which they might inhibit cartilage destruction to slow or halt radiographic progression of the disease. We also contrast these with anecdotal or experimental administration of statins that could equally regulate ADAMTS aggrecanase activity and are available to arthritis sufferers worldwide. Finally, we review the current literature regarding the development of synthetic inhibitors directed toward the aggrecanases ADAMTS4 and ADAMTS5, a strategy that might directly inhibit cartilage destruction and restore joint function in both rheumatoid arthritis and osteoarthritis.

Associations of subjective vitality with DNA damage, cardiovascular risk factors and physical performance

To examine associations of DNA damage, cardiovascular risk factors and physical performance with vitality, in middle-aged men. We also sought to elucidate underlying factors of physical performance by comparing physical performance parameters to DNA damage parameters and cardiovascular risk factors. We studied 2487 participants from the Metropolit cohort of 11532 men born in 1953 in the Copenhagen Metropolitan area. The vitality level was estimated using the SF-36 vitality scale. Cardiovascular risk factors were determined by body mass index (BMI), and haematological biochemistry tests obtained from non-fasting participants. DNA damage parameters were measured in peripheral blood mononuclear cells (PBMCs) from as many participants as possible from a representative subset of 207 participants. Vitality was inversely associated with spontaneous DNA breaks (measured by comet assay) (P=0.046) and BMI (P=0.002), and positively associated with all of the physical performance parameters (all P<0.001). Also, we found several associations between physical performance parameters and cardiovascular risk factors. In addition, the load of short telomeres was inversely associated with maximum jump force (P=0.018), with lowered significance after exclusion of either arthritis sufferers (P=0.035) or smokers (P=0.031). Here, we show that self-reported vitality is associated with DNA breaks, BMI and objective (measured) physical performance in a cohort of middle-aged men. Several other associations in this study verify clinical observations in medical practice. In addition, the load of short telomeres may be linked to peak performance in certain musculoskeletal activities.

Estimating the health-care usage associated with osteoarthritis and rheumatoid arthritis in an older adult population in Ireland

An ageing population leads to increasing prevalence of age-related chronic conditions that present challenges to the health-care services. Despite this, in countries including Ireland, little is known about the health-care impact of conditions such as osteoarthritis or rheumatoid arthritis amongst older adults. A series of count models are developed to investigate the incremental health-care usage of individuals with either osteoarthritis or rheumatoid arthritis on the use of general practitioners (GP) services, outpatients' services, accident and emergency visits and inpatient nights. Both types of arthritic conditions lead to increased usage of GP and outpatients' services but not other hospital services. Differences in entitlements to care, as captured by the presence of a medical card in Ireland, lead to different health-care usage among arthritis sufferers. Translating the additional utilization into cost suggests a combined incremental annual cost of both types of arthritis of €13.6 million. Osteoarthritis and rheumatoid arthritis present challenges to health-care services in the context of an ageing population. In the case of Ireland the burden falls predominantly on primary health-care and outpatient services. Within the context of changing health-care service provision in Ireland, the results of this study have implications for future planning of service delivery.