Geriatric Problems Research Articles

Twenty Years of Arsenic Contamination and Arsenicosis Patients in a Village of Bangladesh

Background: Arsenic contamination in groundwater of Bangladesh was first detected in 1993 and still a major public health problem in the country. In 1997, Samta was identified as a severely arsenic contaminated village and many villagers were found to suffering from arsenicosis. Methods: A series of surveys were carried out in Samta village in the years 1997, 2002, 2008 and 2017 to assess the situation of arsenic contamination and the status of arsenicosis in the village. The water sources and the entire population of the village were included in the study. Results: In 1997 about 87% of the shallow tubewells in Samta village were arsenic-contaminated and 10.1% villagers had arsenicosis. Twenty years later in 2017, about 90% shallow tubewells were arsenic contaminated, 39 deep tubewells and a pond sand filter were installed in the village and 2.3% of the villagers had arsenicosis. On an average 43.8% arsenicosis patients had recovered from the illness and condition of 21.2% patients had deteriorated or remained unchanged. During the 20-year period 37(6.1%) arsenicosis patients and 185(1.6%) non-arsenicosis villagers had died. The main cause of death among arsenicosis patients was cancer (40.5%) and among non-arsenicosis villagers the cause was geriatric problem (11.8%). The mean age at death was 57.6 years and 61.2 years respectively. Conclusion: In twenty years, measures were undertaken to make available arsenic-safe water options and people were motivated to stop the use of arsenic-contaminated water and to increase the intake of protein and vitamin AEC rich food. Recovery had occurred in a substantial proportion of patients.

Types, Characters and Trend of Congenital Anomalies in Thi-Qar / 2 years assessment

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Management of Lung Abscess : Review of 50 cases in Al-Hussein Teaching Hospital / Thi-Qar ( 2013-2018 )

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Congenital Anomalies in Thi-Qar: A Recent Observational Study during 2019

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Tools to manage medical uncertainty

Background and aimsDespite an explosion of evidence-based guidelines, many decisions in clinical practice remain shrouded in uncertainty. Physicians could view ambiguous situations as a source of threat. Uncertainty results from personal lack of knowledge, limits of current medical knowledge and the inability to distinguish between the two. The purpose of this review is to study the prevalence, effects and management of medical uncertainty in clinical practice. MethodsPubMed search for articles on prevalence and management of medical uncertainty. Results and conclusionIntolerance to uncertainty among physicians may result in increased test-ordering tendencies, failure to comply with evidence-based guidelines, guide career choices, and result in decreased comfort with geriatric, chronic illness and psychological problems. Factors causing variability of disease management includes: patient factors(inappropriate prioritization, risk aversion, expectations), physicians factors(lack of knowledge, intolerance to medical uncertainty, limited resources, time constraints), biological variability of patient, health system factors, patients comorbidities, technological and media influences contributing further to unrealistic expectations. Physicians’ perceptions of uncertainty in their daily work vary considerably. Urologist and orthopedic surgeons reported less uncertainty in their daily routine compared to psychiatrists, family practitioners and general internists. Effective methods of managing uncertainty include, consensus building among physicians from 3 or more specialties regarding patients problem, building trust between patients, their physicians and health care systems, thoughtful evaluation with exclusion of worrisome diagnosis, apply evidence-based information with effective risk communication, negotiating management strategies with patient and establishing regular follow-up with personalized feedback. (– 245 words).

Effects of the Training Given to Older Adults on Urinary Incontinence

This study aims to identify the effects of the pelvic floor strengthening exercises and bladder training given to older adults with urinary incontinence on their incontinence. A randomized controlled trial was conducted between March and June 2017. The target population was 476 people aged 65 and over who were diagnosed with urinary incontinence. The sample was 100 volunteer people who met the research criteria. The data were collected using the Socio-demographic Form and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). The experimental group ICIQ-SF post-test mean score was significantly lower than the control group ICIQ-SF post-test mean score. Urinary incontinence is one of the important geriatric problems whose prevalence has been increasing with ageing. Urinary incontinence treatment should include behavioural treatment together with medicine or surgical treatments. This study found that the training given to older adults had preventive effects on urinary incontinence.

Geriatrische Versorgung in ländlichen Regionen: Ergebnisse aus zwei standardisierten Befragungen von Leistungserbringern und Akteuren

BackgroundDue to a growing elderly population the number of age-related diseases increases and thus the need for geriatric care. In rural areas with low population density and few healthcare providers there is a risk of inadequate care. Aim of the studyThe aim of our investigation was to identify gaps in care and preferred improvement approaches in rural areas from the perspective of local care providers. Methods1,545 healthcare providers from two rural regions were surveyed on the care situation (assessment according to the German school grading system), improvement approaches and problems (simple frequencies). The participants’ answers were categorized and analyzed by their work location according to the central-place concept of high-order, middle-order and lower-order (basic) centers. Results348 healthcare providers participated (response rate: 22.5 %). The outpatient and inpatient care situation in geriatrics was rated “satisfactory” on average. Geriatric care is most often jeopardized by long waiting times for specialist treatment (71.0 %). Significant differences in the rating were found in the coverage of geriatric care by inpatient care (p=0.0018) and the accessibility of medical facilities by public transport (p=<0.001). These were better rated in the higher-order centers. The preferred approach to improve care was intersectoral networking (62.3 %) among care providers. ConclusionsIn rural areas, supply problems in geriatrics exist, in particular accessibility and waiting times in middle-order and basic centers. Solutions of regional, intersectoral and interprofessional care were approved by a majority of the participants.

Correlation between geriatric ischemic stroke patient characeteristic and drug related problems

Background: Drug related problems (DRP) can cause problems in treatments of patients with ischemic stroke. Objective: This study was to determine the correlation between the characteristics of patients with ischemic stroke and the DRP. Methods: A population in this study was 53 patients at dr Iskak Public Hospital in Tulungagung. Inclusion criteria were patients who were = 60 years old and were diagnosed as acute ischemic stroke patients. The DRP was classified based on Pharmaceutical Care Network Europe version 6.2, especially problem and cause domain. Correlation between age, duration of treatment, number of comorbidities and number of drugs and the DRP was analysed by Spearman Rho or by Pearson analysis. The relationship between gender, guaranteed care and the DRP was analysed by using Eta analysis. Results: This study revealed that patients with 60-69 years were 24 patients (45.28%), men were 30 patients (57%), 1 comorbidity was 26 patients (49.06%), duration of 5 days was 14 patients (26.42%), BPJS patients were 23 patients (35.94%), using 6 types of drug was 11 patients (20.75%). Age, sex and care guarantee did not correlate with the DRP (p-values > 0.05). Duration of treatment, number of comorbidities and number of drugs correlated with the DRP (p-value <0.05) with consecutive correlation strength: weak (R = 0.32), moderate (R = 0.45), strong (R = 0.56). Conclusion: Duration of treatment, number of comorbidities and number of drugs correlated with increasing incidences of the DRP in geriatric ischemic stroke patients.

Prevalence and Risk Factors of Urinary Incontinence in Frail Elderly Females.

Background/Purpose. Urinary incontinence (UI) is an important geriatric health problem, and it is linked to frailty syndrome. We had conducted a study to detect the prevalence and risk factors of UI and its effect on quality of life (QOL) among frail elderly females living in Cairo, Egypt. Methods. We carried out a cross-sectional study on 130 frail elderly females sixty years and older, attending Ain Shams Geriatrics Hospital, Cairo, Egypt. Each patient gave oral consent and then was subjected to history taking, full clinical examination, diagnosis of frailty (clinical frailty scale), assessment of UI by the Arabic version of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), assessment of QOL by using the Arabic version of Incontinence Impact Questionnaire Short Form (IIQ-7 SF), and complete urine analysis. Results. The prevalence of UI among the studied population was 80%. Mixed UI was the most prevalent type. UI was significantly associated with older age, functional impairment, multiparity, osteoarthritis, stroke, vaginal prolapse, and laxative use. All IIQ-7 subscales were higher (worse health-related QOL) for women with mixed UI. Conclusion. Urinary incontinence is prevalent in frail elderly females. Mixed UI, compared with other types, has a significant negative impact on all domains of quality of life.

Multidimensional Approach to Frailty.

The concept of frailty syndrome (FS) was first described in the scientific literature three decades ago. For a very long time, we understood it as a geriatric problem, recently becoming one of the dominant concepts in cardiology. It identifies symptoms of FS in one in 10 elderly people. It is estimated that in Europe, 17% of elderly people have FS. The changes in FS resemble and often overlap with changes associated with the physiological aging process of the body. Although there are numerous scientific reports confirming that FS is age correlated, it is not an unavoidable part of the aging process and does not apply only to the elderly. FS is a reversible clinical condition. To maximize benefits of frailty-reversing activities for patient with frailty, identification of its determinants appears to be fundamental. Many of the determinants of the FS have already been known: reduction in physical activity, malnutrition, sarcopenia, polypharmacy, depressive symptom, cognitive disorders, and lack of social support. This review shows that insight into FS determinants is the starting point for building both the comprehensive definition of FS and the adoption of the assessment method of FS, and then successful clinical management.

Prevalence of Geriatric Syndromes in Elderly Cancer Patients Receiving Chemotherapy.

The number of elderly patients with cancer is growing. Our study goals were to determine the prevalence of geriatric syndromes in elderly cancer patients receiving chemotherapy and its related factors using a basic geriatric screening tool. A cross-sectional study using the basic geriatric screening tool was conducted to survey geriatric problems in a population of elderly cancer patients receiving chemotherapy. There were 85 participants who were ≥60 years old. Descriptive statistics and regression analyses were used. The prevalence of having at least one geriatric syndrome was 58.8% (50 out of 85 cases). Depression was the most common component both in male and female patients. Age ≥65 years old was significantly associated with the geriatric syndrome (AOR 4.23, p=0.018), and a factor associated with depression was underweight (BMI<18.5 kg/m2) (AOR 13.2, p=0.003). In summary, geriatric syndromes are common in elderly cancer patients. Screening for geriatric syndrome adds substantial data on the assessment of elderly cancer patients, even those with a good performance status.

Chemical Hip Denervation for Inoperable Hip Fracture.

Hip fracture is a challenging geriatric problem for the health care professionals, especially in patients with multiple comorbidities. In patients with inoperable hip fracture secondary to severe comorbid conditions, the pain can lead to significant challenges in nursing care. With the current understanding of the innervation of hip joint, we are now able to perform selective chemical denervation of the articular branches of femoral and obturator nerves to manage the pain associated with inoperable hip fracture. In this retrospective case series, we analyzed 20 consecutive patients with inoperable hip fracture who received chemical denervation and examined the effect of the denervation on pain and functional outcomes, including the maximally tolerable hip flexion and the ability to sit during their hospital stay. We also assessed the likelihood of being ambulatory as a long-term outcome. The movement-related pain was significantly reduced at 10 minutes postprocedure, on postintervention days 1 and 5 (P values of <.001), and the degree of maximally tolerable hip flexion was doubled at the same time points (P values of <.001, .003, and .002, respectively). Fifty percent of the patients managed to sit within the first 5 days after procedure, and 3 of them managed to walk with aid 4 months after hip denervation. No procedural adverse event was noted. We concluded that this chemical hip denervation could be a safe and effective measure to handle the pain-related and rehabilitation-related challenges as a result of inoperable hip fracture.

Geriatric ophthalmology &amp; Rasayana - Ayurvedic perspective.

Aging is the process of physiological psychological and social change in multidimensional aspects. As like the other structures of human body it is obvious and inevitable that the eye is also involved with various ailments leading to the manifestations of different ocular diseases in old age Among them important diseases are cataract, presbyopia, glaucoma, age related macular degeneration and diabetic retinopathy etc The pathological lesions in old age according to the ayurvedic concepts are swabhavika vhyadhis and it is difficult to cure completely so with an intension delay the Aging process Acharya recommend to start Rasayana therapy in middle age. Rasayana becomes more treat full and effective if it is preceded with suitable panchakarma. Triphala churna is advisable to all patients with diminished vision along with the honey and ghruta in unequal quantity which act as a Rasayana. As geriatric problems are not attributed to a single cause, the treatment should be planned according to stage of the disease and the involved dosha on the basis of that we are treating the diseases by applying Classical ayurvedic measures along with kriyakalpa. Intake of Rasayana in middle of the age followed by panchakarma, adopting pratimarsha nasya, doompana, gandoosha and Anjana as din charya administration of medication in early stage of disease are helpfull in delaying or arresting senile ocular condition.

Video-based time assessment in 360 degrees turn Berg balance test

The Great Geriatric Problems include dementia syndromes, locomotion disorders, and falls. In geriatrics, one of the most commonly used methods for assessing the balance of seniors is the Berg Balance Scale (BBS). It is a set of 14 exercises that reflect daily activates. In this paper focused on the 11th Berg Balance Test, a novel method is introduced, based on the time of rotation calculated using the CamShift algorithm. The method is tested on 57 recordings of seniors. The average relative error of presented method is 4.74%, which refers to the average absolute error at the level of 0.83 s.

Arterial hypertension in older adults: who needs geriatric approach?

Elevated blood pressure (BP) is an important risk factor not only for cardiovascular morbidity and mortality, but also for cognitive decline and loss of autonomy in later life. Randomized clinical trials (RCTs) in populations of older patients living at home with low comorbidity and preserved autonomy showed benefits of decreasing the elevated BP in patients older than 80 years. Older patients with frailty, loss of autonomy and other geriatric problems were systematically excluded from the RCTs. Observational studies in these groups of patients showed an increase in morbidity and mortality at a lower level of BP during antihypertensive therapy. Obviously, in very elderly patients a universal strategy for the BP lowering cannot be applied due to the significant heterogeneity of their functional status. In this review geriatric approach based on assessment of the functional status of the elderly patient, the presence of frailty and degree of loss of autonomy as a basis for decision-making process regarding the antihypertensive therapy is discussed.

Study of Depressive (Psychiatric) Problems in Elderly Population of Telangana

In the present study 95 male and 83 female elderly Depressive (psychotic) patients aged between 65 to 75 years studied in males 45(47.3%) were dementia, 25(26.3%) had depressive illness, 11(11.5%) were manic, 10(10.5%) were anxiety, 4(4.2%) had paranoid psychosis. In female 36(43.3%) had dementia 20(24) had depressive illness 8(9.6%) had paranoid 4(4.8%) had hallucination 9(10.8%) had anexity. Apart from this disease associated with geriatric psychotic patients were also studied in males. 20(21%) D.M, 26(25.2%) had osteo–arthritis, 7(7.3%) had constipation 22(23.1%) had family conflicts, 1(13%) had death of life partners or close relatives. 9(9.4%) had a sudden loss in business. In Female geriatrics 30(36.1%) D.M, 23(27.7%), 22(26.5%) had family conflicts, 8(9.6%) had death of life partner or close relative. In the study of suicidal tendencies due to severe depression 65(68.4%) of males, 60(72.2%) female had suicidal ideation, and 30(31.5%) male 23(27.7%) females were attempted for suicide. This study of various psychotic patients will certainly help the psychiatrist to treat the old aged patients efficiently and meticulously, and it conveys a massage to surgeons, and physicians to take opinion of psychiatrist during the treatment of geriatric patients so that they can be cured physically and mentally and live with confident and face the challenges of the geriatric problems.

Community diagnosis by conducting family health survey in the field practice area of a medical college

Background: In a developing country like India, with limited resources health needs of individuals and community are enormously increasing. Health related problems may be addressed amicably by community diagnosis. Assessment and prioritization of health issues followed by formulation of action plans with strategies and their implementation can be effectively achieved, by using family health surveys.Methods: Using family health survey 500 families, constituting 2640 individuals were studied. Their health status and socio-demographic details were taken. Households and families were selected randomly. Data entry and analysis was done by appropriate use of statistical tools.Results: Study showed 52.27% males and 47.73% females. Majority (51.5%) belonged to 16-45 years followed by 6-15 years of age (25%). Among 9.09% of the under-five, fully immunized were 90.4% and partially immunized were 9.6%. 6.06% were above 60 years. Nuclear families were 68%. Majority (36%) of the families belonged to socio-economic class II (modified B.G. Prasad classification). 10.6% were illiterate and 11.3% were below seven years of age. Overcrowding was present in 24% of the families. Common morbidities were hypertension (32.2%), diabetes (26.9%), respiratory diseases (19.2%) eye problems (6.2%) and skin diseases (3.8%). Geriatric problems were present in one out of four individuals.Conclusions: Family health survey can be used as an educational tool for undergraduate medical students to understand common morbidities and determinants of diseases in the community. Family health surveys are important for a community as necessary intervention can be done for illnesses and health-related problems.

Болезнь Альцгеймера и искусственный интеллект: долговременная персонифицированная реабилитация и медико-социальное сопровождение

Modern technologies and tools for the rehabilitation of patients with Alzheimer’s disease have many potential applications for the treatment of dementia from diagnosis and evaluation to medical care, medical, social and economic support: from healthy aging, to accelerated and pathological aging of Homo sapiens. Doctor and neuroscientist: a modern solution to problems of rehabilitation ‘cognitive brain’ of Homo sapiens using on the one hand, tools and technologies of artificial intelligence, and with another — a multidisciplinary collaboration with clinical neurophysiologist ‘universal’ specialist in the field of neurology, psychiatry, psychotherapy, psychoanalysis and geriatrics. Systems biology, Biophysics, physiology, neurophysiology and highlight the multidimensional and combinatorial profiles of genetic, biological, pathophysiological and clinical biomarkers that reflects the heterogeneity of neurodegeneration, by means of modern efficient analysis tools to register and create comprehensive maps of the brain and recording of dynamic models in different systems: from molecules to neurons to brain regions. Bioinformatics, neuroimaging and neurophysiology of systems are aimed at calculating neural network models of the relationship between structure and dynamic function in brain networks. Structural and functional markers of the brain establish a link between clinical phenotypes and molecular pathophysiological mechanisms. Phenotypic variability is now considered one of the biggest problems in gerontology and geriatrics. MRI imaging to detect subtle changes in brain tissue and structure, fMRI imaging to measure changes in brain activity, and EEG to measure electrical activity have given clinicians many new insights into what happens in the brain in healthy and pathological aging. The paradigm of system neurophysiology is aimed at studying the fundamental principles of functioning of integrated neural systems through the integration and analysis of neural information recorded in a multimodal way (for example, fMRI and EEG), through computational modeling and combining data mining methods. The ultimate goal of systemic neurophysiology is to find out how signals are represented in neocortical networks and what role many different neural components play. Modern artificial intelligence technologies are capable of many things, including predicting Alzheimer's disease with the help of combined and hybrid neuroimaging, sequencing of a new generation, etc., in order to start timely and effective rehabilitation brain Homo sapiens.

Geriatric health related problems in an urban area of southern Rajasthan

Background: There is a paradigm shift in the social values towards the elderly people due to urbanization and higher educational linked migration. Consequently, problems like loneliness, lack of emotional support, economic insecurities are faced by the elderly population. The objectives of the study were to assess the socio-economic dimensions and to examine the morbidity and mortality patterns of elderly persons in the study area.Methods: A cross- sectional study was conducted among 536 elderly persons from May to August 2019 in an urban area of Udaipur. A pre-structured and pre-tested questionnaire was used to collect information on socio-demographic details, morbidity profile and socio-economic problems of elderly persons. The data was analyzed using class frequencies, ‘t’ test for equality of gender difference in mortality ages and Chi-square test for association of age class with morbidity.Results: A majority of study subjects were females (52.05%). There was significant difference in proportions of elderly male and female persons across their educational levels. The chi-square test for association of age classes with number of health problems revealed significant association. About 56.34% of 536 elderly people were leading an unsatisfactory life.Conclusions: The major morbidities included arthritis, hypertension, diabetes, cataract, dental problems, cardiovascular problems etc. Financial problems were more severe among elderly. The availability of trained paramedical professionals for home care and day care units and legal bindings on family members for safety and security of elderly person can be effective measures to overcome the problems being faced by them.

The prevalence and impact of falls in elderly dialysis patients: Frail elderly Patient Outcomes on Dialysis (FEPOD) study

BackgroundAs the numbers of older patients on dialysis rise, geriatric problems such as falling become more prevalent. We aimed to assess the prevalence of falls and the impact on mortality and quality of life in frail elderly patients on assisted PD (aPD) and hemodialysis (HD) from the FEPOD Study. MethodsData on falls and quality of life were collected with questionnaires at baseline and every six months during 2-year follow-up. Multiple regression analysis was used to evaluate factors associated with falls. Additionally, we performed a review of literature concerning the relation between falls and poor outcome. ResultsBaseline fall data were available for 203 patients and follow-up data for 114 patients. Dialysis modality was equally distributed (49% HD and 51% aPD). Mean (SD) age was 75 ± 7 years. Fall rate was 1.00 falls/patient year, comparable in HD and aPD. Falls led to fear of falling, resulting in less activities in 68% vs 42% (p < 0.01) and leaving the house less in 59% vs 31% (p < 0.01) of patients. Patients with diabetes mellitus were twice as likely to report falls at baseline (OR 1.91 [95%CI 1.00–3.63], p = 0.05) and falls at baseline were associated with falls during follow-up (OR 2.53 [95%CI 1.06–6.04] p = 0.03). Literature revealed frailty was a strong risk factor for falling and falling results in a higher mortality and hospitalization rate. ConclusionFalls were frequent in older dialysis patients and have a negative impact on quality of life. Fall incidence is comparable between aPD and HD.