Health Of Elderly Patients Research Articles

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective: The study aimed to assess medication management compliance and mental health in elderly patients with hypertension. Method: The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling. Data was collected using the Morisky Medication Compliance Questionnaire, Hospital Anxiety and Depression Scale, and a checklist. Ethical practices were strictly observed. Results: A study of 100 elderly hypertensive patients found poor drug management compliance, with female patients showing worse compliance. Female patients were more vulnerable to anxiety and depression. The study also found no significant association between gender, age, education level, marital status, living standards, and medication compliance. Barriers to medication management included food and daily necessities, lack of awareness about the importance of drug treatment, and basic family needs. The lowest-ranked barriers were lack of support from government health clinics, low income, and lack of family support. Conclusion: Based on the results, the study proposes an educational plan for elderly hypertensive patients and their families, to be evaluated and implemented by the hospital and township community service center. The plan aims to improve medication management and lifestyle modification compliance, encourage active participation, and provide access to medical and mental health clinics, support groups, and counseling services.

Early Changes in Nutritional Status of Elderly Patients with Lung Cancer Undergoing Chemotherapy Are Positively Related with Symptoms of Depression: A Prospective Follow-Up Study

This study aims to assess early effects of chemotherapy on symptom alleviation, nutritional status, and mental health in elderly patients with advanced non-small-cell lung cancer (NSCLC). This prospective study included 45 NSCLC patients (32 males, 13 females) aged 65–82 years (mean age 70.0 ± 4.5 years) with good performance status. Assessments were conducted immediately after diagnosis and after two chemotherapy cycles, focusing on nutritional status (assessed with MNA questionnaire), quality of life (QoL, based on FACT-L and FACT-TOI questionnaires), lung cancer-related symptoms (based on LCSS), and mental health (based on PHQ-9 questionnaire). Despite significant alleviation of symptoms like cough, dyspnea, and body weight loss, there was no significant correlation between changes in symptoms burden and changes in nutritional status (r 2 = 0.122, P = 0.427), and change of patients’ mental condition (r 2 = –0.141, P = 0.255). No significant QoL changes were noted, but a decrease in severe depression frequency was observed. The improvement of patients’ mental condition was related strictly to the improvement of nutritional status (r 2 = -0.589, P < 0.001). The study highlights the vital link between nutritional status and mental health in elderly NSCLC patients, emphasizing the need for integrated care approaches that address both aspects to enhance treatment effectiveness and patient well-being.

Effects of a Dietary Supplement Containing Collagen - L-Arginine - Hyaluronic Acid on General Health in Elderly Patients with Musculoskeletal Complaints

Effects of a Dietary Supplement Containing Collagen - L-Arginine - Hyaluronic Acid on General Health in Elderly Patients with Musculoskeletal Complaints

Oral health in elderly patients

Oral health in elderly patients

Evaluating the effects of S-ketamine on postoperative delirium in elderly patients following total hip or knee arthroplasty under intraspinal anesthesia: a single-center randomized, double-blind, placebo-controlled, pragmatic study protocol

IntroductionPostoperative delirium (POD) is an acute, transient brain disorder associated with decreased postoperative quality of life, dementia, neurocognitive changes, and mortality. A small number of trials have explored the role of S-ketamine in the treatment of POD due to its neuroprotective effects. Surprisingly, these trials have failed to yield supportive results. However, heterogeneity in delirium assessment methodologies, sample sizes, and outcome settings as well as deficiencies in S-ketamine use methods make the evidence provided by these studies less persuasive. Given the severe impact of POD on the health of elderly patients and the potential for S-ketamine to prevent it, we believe that designing a large sample size, and rigorous randomized controlled trial for further evaluation is necessary.MethodsThis is a single-center, randomized, double-blind, placebo-controlled, pragmatic study. Subjects undergoing total hip or knee arthroplasty will be randomized in a 1:1 ratio to intervention (n = 186) and placebo (n = 186) groups. This trial aims to explore the potential role of S-ketamine in the prevention of POD. Its primary outcome is the incidence of POD within 3 postoperative days. Secondary outcomes include the number of POD episodes, the onset and duration of POD, the severity and subtype of POD, pain scores and opioid consumption, sleep quality, clinical outcomes, and safety outcomes.DiscussionTo our knowledge, this is the first pragmatic study that proposes to use S-ketamine to prevent POD. We reviewed a large body of literature to identify potential preoperative confounding variables that may bias associations between the intervention and primary outcome. We will use advanced statistical methods to correct potential confounding variables, improving the test’s power and external validity of test results. Of note, the patient population included in this trial will undergo intraspinal anesthesia. Although large, multicenter, randomized controlled studies have found no considerable difference in the effects of regional and general anesthesia on POD, patients receiving intraspinal anesthesia have less exposure to at-risk drugs, such as sevoflurane, propofol, and benzodiazepines, than patients receiving general anesthesia. At-risk drugs have been shown to negatively interfere with the neuroprotective effects of S-ketamine, which may be the reason for the failure of a large number of previous studies. There is currently a lack of randomized controlled studies evaluating S-ketamine for POD prevention, and our trial helps to fill a gap in this area.Trial registration: http://www.chictr.org.cn, identifier ChiCTR2300075796.

Risk factors of osteoporosis in elderly inpatients: A cross-sectional single-centre study.

Objective: This study aimed to identify factors significantly associated with the occurrence of osteoporosis in elderly and very elderly patients. Methods: Elderly hospitalized patients who were older than 60years old, from the Rehabilitation Hospital from December 2019 to December 2020 were selected. Barthel index (BI), nutritional assessment, the causes of bone mineral density (BMD) reductions in elderly and elderly patients were analysed. Results: A total of 94 patients (83.56 ± 8.37years old) were enrolled. With increasing age, the BMD of the lumbar spine, femoral neck, and femoral shaft of elderly patients significantly decreased, and the incidence of osteoporosis (OP) significantly increased. The BMD of the lumbar spine was negatively correlated with female and positively correlated with serum 25-hydroxyvitamin D levels, the difference between actual body weight and ideal body weight, and blood uric acid levels; The BMD of the femoral neck was negatively correlated with age and female, and positively correlated with height and geriatric nutrition risk index score. The BMD of the femoral shaft was negatively correlated with female and positively correlated with BI. Conclusion: With increasing age, the BMD of the lumbar spine and the femoral shaft significantly decreased, and the incidence of OP significantly increased in elderly and very elderly patients. Aric acid may protect bone health in elderly patients. Early attention to the nutritional status, exercise capacity, 25-hydroxyvitamin D level, and blood uric acid level in the elderly population can help identify high-risk elderly patients with OP.

Influence Of Baseline Comorbid Diseases on Major Depression and The Effect of Intensive Medical Treatment on Functional Mobility in Depressed Patients Compared with Those Without Depression

Objectives Somatic diseases, depression and functional mobility were examined in a follow-up study in geriatric patients. The first aim of the study was to assess the independent and moderator effects of baseline diseases on depression before adjustment by examining whether this influence will sustain or switch after adjustment. The second aim was to explore the differential treatment outcomes in functional mobility in depressed patients versus those with no depression. Methods A sample of n = 1,816 multimorbid patients consisting of n = 902 with a diagnosis of major depression and their counterparts n = 914 without depression were examined at two time points. They all underwent acute rehabilitation. Those who were diagnosed with major depression received an antidepressant and psychotherapy treatment. Depressive symptoms were recorded with the Geriatric Depression Scale. Functional mobility was measured using the Tinetti Test. Results We found that 431 patients (47%) were in partial remission at follow-up. The results yield a significant improvement in functional mobility in both groups as an effect of the intensive rehabilitation program. These findings support published findings highlighting an overall functional health enhancement owing to a combined medical rehabilitation, antidepressant and psychotherapeutic treatment as a result of early intensive rehabilitation for elderly patients with multiple medical conditions. The findings show that elderly patients with multiple chronic conditions benefit from intensive rehabilitation, psychotherapy and antidepressant treatment within three weeks of intensive stationary treatment. Results showed that baseline comorbid diseases (mainly focal neurologic deficits and coronary artery diseases) each act as risk factors for major depression before treatment. An intercept effect was unveiled between obesity and arterial hypertension that arises as risk factors for depression before adjustment. After adjustment, we found that baseline chronic conditions, specifically coronary artery disease, focal neurologic deficits, heart or valvular insufficiency, artificial valvular or pace maker and tumour diagnosis in respiratory organ each act as a potential risk factor for depression occurrence. The intercept effect erased after treatment. Functional health was increased significantly in both groups at follow-up. However, there was no difference in the increase of functional mobility (Tinetti Test) in non-depressed and depressed patients following the rehabilitation. Conclusion The results bolster up the conjecture that specific somatic diseases influence major depression before and after treatment and support an association between somatic diseases, depression, and functional health in elderly patients. In depressed and non-depressed patients, geriatric rehabilitation boosts functional mobility, which is crucial for the maintenance of autonomy in elderly patients. Major depression may hamper functional mobility rehabilitation’s outcome only if not well managed or overlooked.

Interaction Effect of Phase Angle and Age on Femoral Neck Bone Mineral Density in Patients with Non-Dialysis Chronic Kidney Disease Stage 5.

Background: Low bone mass is common in malnourished patients with chronic kidney disease (CKD) and can lead to a higher risk of fractures. Elderly and CKD patients have the same risk factors for protein-energy wasting, sarcopenia, and osteoporosis. Here, we investigated the association between phase angle (PhA) and bone mineral density (BMD) in dialysis-naïve patients with CKD stage 5 (CKD5) and identified a statistical relationship between PhA and age, which affects bone density. Methods: Bio-impedance spectroscopy for evaluating body composition and PhA and dual-energy X-ray absorptiometry for determining the BMD were simultaneously performed in 167 consecutive patients (mean age, 59.65 ± 13.98 years; women, 40.1%). Two-way analysis of variance (ANOVA) was conducted to assess the potential interaction effect of PhA and age on femoral neck BMD (FN-BMD). Results: Our results showed that PhA and age were independently associated with FN-BMD and T-score in multiple linear regressions analyses. A significant interaction effect of PhA and age on FN-BMD was found on two-way ANOVA (p = 0.028). The average BMD values for the first and second tertiles of the PhA were higher in the young versus elderly group, whereas patients in the elderly group had higher BMD in the third tertiles. Conclusions: A relationship was noted between PhA and BMD in patients with advanced-stage CKD. The effect of PhA level on FN-BMD differed between elderly and young patients. Our study suggested that higher PhA levels could be a marker explaining the maintenance of good bone health in elderly patients with CKD5. Further longitudinal analyses are needed to determine whether PhA predicts the risk of CKD-MBD-related fractures during CKD progression.

Association of long-term time in target range for systolic blood pressure with cardiovascular risk in the elderly: a Chinese veteran cohort study.

Short-term blood pressure (BP) time in target range (TTR) independently predicts cardiovascular (CV) outcomes in adults. However, there are limited data regarding long-term TTR for BP among elderly participants. We aimed to determine whether future CV risk varies for those who can maintain a long-term systolic BP (SBP) target range by assessing TTR in elderly individuals with hypertension. The Chinese veteran cohort study included 943 elderly participants with hypertension aged over 75 years. The primary outcome was the first occurrence of CV events during annual visits. Time in target range was estimated over 15 years of follow-up using linear interpolation. The target range was defined as 120-140 mmHg according to guidelines. The association between SBP TTR and CV outcomes was estimated using multivariable Cox proportional hazards models. During the 15 year follow-up, the probability of CV events gradually decreased with increasing TTR for SBP. After multivariable adjustment for traditional CV risk factors and mean BP, comparing the highest vs. lowest quartiles of TTR for SBP, the hazard ratios (HRs) [95% confidence intervals (CIs)] were 0.424 (0.289-0.624) for the primary outcome. For each 1 SD increase in TTR, the risk of the primary outcome decreased by 25.4% (HR: 0.746; 95% CI: 0.666-0.834). Consistent findings were observed in sensitivity analyses. Greater long-term TTR for SBP was associated with a decreased risk of CV events in elderly individuals independent of mean BP, suggesting that SBP TTR might serve as a modifiable risk factor for future CV health in elderly patients with hypertension. This ongoing Chinese veteran cohort study adds to the understanding of the relationship between higher long-term systolic blood pressure (SBP) time in target range (TTR) and cardiovascular benefits among elderly individuals with hypertension.

Differential bone adaptation to mechanical unloading and reloading in young, old, and osteocyte deficient mice.

Mechanical unloading causes rapid loss of bone structure and strength, which gradually recovers after resuming normal loading. However, it is not well established how this adaptation to unloading and reloading changes with age. Clinically, elderly patients are more prone to musculoskeletal injury and longer periods of bedrest, therefore it is important to understand how periods of disuse will affect overall skeletal health of aged subjects. Bone also undergoes an age-related decrease in osteocyte density, which may impair mechanoresponsiveness. In this study, we examined bone adaptation during unloading and subsequent reloading in mice. Specifically, we examined the differences in bone adaptation between young mice (3-month-old), old mice (18-month-old), and transgenic mice that exhibit diminished osteocyte density at a young age (3-month-old BCL-2 transgenic mice). Mice underwent 14days of hindlimb unloading followed by up to 14days of reloading. We analyzed trabecular and cortical bone structure in the femur, mechanical properties of the femoral cortical diaphysis, osteocyte density and cell death in cortical bone, and serum levels of inflammatory cytokines. We found that young mice lost ~10% cortical bone volume and 27-42% trabecular bone volume during unloading and early reloading, with modest recovery of metaphyseal trabecular bone and near total recovery of epiphyseal trabecular bone, but no recovery of cortical bone after 14days of reloading. Old mice lost 12-14% cortical bone volume and 35-50% trabecular bone volume during unloading and early reloading but had diminished recovery of trabecular bone during reloading and no recovery of cortical bone. In BCL-2 transgenic mice, no cortical bone loss was observed during unloading or reloading, but 28-31% trabecular bone loss occurred during unloading and early reloading, with little to no recovery during reloading. No significant differences in circulating inflammatory cytokine levels were observed due to unloading and reloading in any of the experimental groups. These results illustrate important differences in bone adaptation in older and osteocyte deficient mice, suggesting a possible period of vulnerability in skeletal health in older subjects during and following a period of disuse that may affect skeletal health in elderly patients.

EFEITO DE RESISTÊNCIA AO EXERCÍCIO NA TAXA DE REAÇÃO ADVERSA DA INSUFICIÊNCIA CARDÍACA

ABSTRACT Introduction: Heart Failure is a common disease in the elderly. In the end stage, patients usually accompany a reduction in fat content and lean body mass in addition to heart failure. Objective: Study the exercise resistance effects and adverse reaction rate in patients with heart failure. Methods: 52 patients with chronic heart failure (38 males, age 67 ± 2.2 years) were randomly divided into two groups. According to New York Heart Association Functional Classification, 27 patients with grade II and 25 with grade I was randomly divided. The experimental group was submitted to aerobic exercises under heart rate control for seven months and the control group with no exercise prescription. In the comparison, the 6-minute walk test and a cardiac function test were employed by Agilent 4500 EcoDoppler at a frequency of 2.5MHz. The indices of systolic and left ventricular function were recorded on ECG simultaneously using the improved Simpsons method, and the following indices were measured: left ventricular systolic and end-diastolic; left ventricular ejection fraction; left ventricular diastolic function; early, late peak velocity and its ratio; mitral valve diastole. Results: Compared to the control group, heart rate decreased to different degrees (P &lt; 0.05), exercise endurance increased significantly (P &lt; 0.01), and left ventricular function index improved significantly (P &lt; 0.01). Conclusion: We observed a positive impact of aerobic exercise directed at the rehabilitation of the cardiovascular system and mental health in elderly patients. Evidence Level II; Therapeutic Studies – Investigating the results.

Assessment of oral health in elderly patients with dementia by measuring volatile sulfur compounds and its relationship with pneumonia development: A pilot study.

This study aimed to clarify the involvement of anaerobes in aspiration pneumonia by measuring volatile sulfur compounds (VSCs), which are metabolites of anaerobic bacteria in the mouth. This study included 84 older adult patients (mean age, 82.5±7.34 years) who had dementia and were hospitalized for more than 6 months. We measured the VSCs in the patient's mouth with Oral Chroma and obtained the data of pneumonia development in the past 6 months. We also evaluated the association or correlation of VSCs and some factors which might be the risk factors of aspiration pneumonia. The development of pneumonia had no significant association with the VSCs in the patient's mouth. The present pilot study suggests that anaerobes might not be the main causative pathogens of aspiration pneumonia in older adult patients.

Selection of Comprehensive Assessment Categories Based on the International Classification of Functioning, Disability, and Health for Elderly Patients with Heart Failure: A Delphi Survey among Registered Instructors of Cardiac Rehabilitation.

The development of a comprehensive assessment tool based on the International Classification of Functioning, Disability, and Health (ICF) for elderly patients with heart failure is urgently required. In this study, we classified the ICF categories relevant to heart failure in the elderly through a Delphi survey (3-step questionnaire survey) of 108 Registered Instructors of Cardiac Rehabilitation in the Hiroshima Prefecture. Questionnaires were conducted using postal mail or a web-based platform. The survey was conducted three times, and the survey results were provided as feedback to the participants in the second and third rounds. More than 80% of the respondents selected categories according to the ICF core set methodology. Data were collected from December 2018 to March 2019, with 67, 54, and 46 participants in the first, second, and third rounds, respectively. A total of 58 ICF items were adopted based on the results: 27 body function items, 4 body structure items, 20 activity and participation items, and 7 environmental factor items. This study is characterised by the inclusion of a large number of ICF items for mental function. This result seems to be influenced by the increasing interest in cognitive dysfunction in elderly patients with heart failure. The ICF categories selected for this study allow for a comprehensive assessment of clients for occupational therapy. The findings of this study are expected to provide a basis for an outcome measure to determine the effectiveness of occupational therapy for these patients.

Poor Oral Health Is a Factor that Attenuates the Effect of Rehabilitation in Older Male Patients with Fractures.

Poor oral health can lead to poor general health. We hypothesized that poor oral health might be a factor that attenuates the effect of rehabilitation in older patients with fractures. This study aimed to evaluate the relationship between oral health in elderly patients with fractures and improvement in activities of daily living (ADL) through rehabilitation. In addition, we assessed factors associated with ADL improvement among older patients with fractures. This case-control study was conducted at a rehabilitation hospital among 178 men aged ≥65 years who underwent fracture rehabilitation. Patients were divided into two groups based on the oral health assessment tool (OHAT) score on admission (≥4 and <4). Analysis of comparison between the two groups and multivariate linear regression analyses were performed, with respect to functional independence measure (FIM) gain during rehabilitation. FIM gain was significantly lower in the group with OHAT score ≥4 (26.2±17.5) than that in group with OHAT score <4 (31.1±16.1, p=0.044). There were also significant differences between the two groups in body mass index values, Mini Nutritional Assessment Short Form (MNA-SF) scores, and fracture types. OHAT score on admission was significantly associated with FIM gain during hospitalization (coefficient: 6.350, 95% confidence interval: 1.043-11.658, p=0.019). FIM on admission, Mini-Mental State Examination score, and period of rehabilitation were significantly associated with FIM gain. We demonstrated that the group with poor oral health had lesser ADL improvement than the group with good oral health. In addition, oral health and period of rehabilitation were independent factors that significantly affected ADL improvements. Older patients with poor oral health should be encouraged to undergo further rehabilitation, and to not refrain from exercise because of old age and fractures.

Increased expression of LCN2 formed a positive feedback loop with activation of the ERK pathway in human kidney cells during kidney stone formation

Kidney stones are a common threat to the health of elderly patients with a high incidence of disease. However, the specific molecular mechanism of the formation of kidney stones has not been elucidated. Here, we combined signalling molecules with signalling pathways in a double positive circulation regulation model. In addition, we found that LCN2 plays a role in promoting kidney stones through regulation of the ERK signalling pathway and expression of other kidney stone-related genes. LCN2 expression was upregulated upon oxalate stimulation. P-ERK1/2 inhibition by U0126 in kidney epithelial cells resulted in decreased expression of LCN2. Furthermore, the upregulation of LCN2 not only depended on the activation of the ERK signalling pathway but also regulated the activation of the ERK signalling pathway. Importantly, upregulation of LCN2 not only caused kidney epithelial cell damage but also promoted the expression of other kidney stone-related genes. Our findings improved the understanding of LCN2 and might lead to the development of new therapeutic and prognostic markers for kidney stones.

Literature Review: Personal Health Record Untuk Meningkatkan Perawatan Kesehatan Lansia

Introduction: Personal health record is a patient's personal health record data. The role of personal health records in improving the health of the elderly is still not efficient. Patients are still constrained in accessing and controlling health record data independently. Patients find it difficult to obtain and adopt integrated information about personal health record data that is contained in the health care provider. Another problem is that patients experience limited integration of health records related to security issues such as confidentiality and privacy of health records. Research method : This type of literature study is a literature review. The research objective was to determine the effectiveness of the role of personal health records in improving elderly health care. The search strategy for English studies relevant to the topic was carried out using the ScienceDirect, SagePub, Springer databases limited from 2015 to 2020. The keywords used were “personal health record”, “elderly”, “health care”. Full text articles were reviewed to select studies that matched the criteria. The inclusion criteria in this review were: personal health records, and elderly. A search using the above keywords with the ScienceDirect, SagePub, Springer databases that matched the inclusion criteria was only 13 articles. Research results : The research reviewed in this article uses a variety of methods, namely implementing and evaluating, analyzing and modeling, multi-method descriptive study, mixed-methods study, user-centered design, systematic review, research model and an empirical study, one- way anonymous, mixed design experiment, survey, qualitative interview study, systematic review, study was reviewed and approved. Research using random technique consists of 1 article, while using non-random technique is 12 articles. Conclusion : The role of personal health records can provide information about the health of elderly patients, especially nursing care services based on patient health records. So that this information can be used as a basis for making nursing interventions that are appropriate to the condition of the elderly at that time.

An overview of Chinese multidisciplinary expert consensus on perioperative brain health in elderly patients.

An overview of Chinese multidisciplinary expert consensus on perioperative brain health in elderly patients.

The medical social characteristic of patients of private stomatological clinics

The article deals with results of anonymous questionnaire survey of patient in private dental clinics "LiderDent" (241 respondents of able-bodied age) and "GelioDent" (419 respondents of able-bodied age). The purpose of the study was to investigate peculiarities of medical and social characteristics. The questionnaire included questions concerning social status of respondents, their financial condition, self-assessment of dental health and its maintenance at the proper level for a number of parameters, as well as evaluation of work of private dental organizations. The assessment of dental health of elderly patients established that 58.1% of respondents rated their dental health as good, 27.8% as satisfactory; and 4.1% of respondents estimated their dental health as bad. The analysis included also evaluation of negative health habits of respondents resulting in dental diseases and afflict damage to teeth and oral cavity. It was found that more than half of respondents had higher education. They consider themselves as financially secure, they did not smoke and had good condition of oral cavity. They choose dentists according recommendation of friends and seek dental care only in case of obvious signs of disease. The analysis of possible reasons for seeking dental professional revealed that 75.5% of respondents seek dental care when there are "obvious signs of disease and deterioration of health", 21.2% "when first signs of disease occurred" and 3.3% "only in critical situation". It is concluded that dental professional of private medical centers should be more widely carried out sanitary and educational work with population in order to increase the medical activity of patient, as well as to increase their awareness of ways and means of maintaining the dental health.

A atuação do cirurgião dentista na odontogeriatria: uma revisão de literatura

Objetivo: Analisar o papel do Cirurgião Dentista (CD) no atendimento aos pacientes idosos, buscando expor as especificidades da assistência geriátrica, como também apresentar ocorrências comuns ao paciente idoso que venham ser um fator limitante ao seu tratamento. Métodos: procedeu-se através de uma revisão de literatura, com interpelação descritiva e informativa, em que a metodologia de preceitos se deu por meio de buscas por literaturas cientificas, em bases de dados, tendo como descritores: Odontologia geriátrica, os cuidados da cavidade oral em pacientes idosos e atendimentos especializados. Resultados: O CD no âmbito geriátrico executa um emprego no aspecto da integralidade multiprofissional, visando a promoção da saúde bucal em pacientes da terceira idade, levando em consideração sempre as condições sistêmicas e psicossociais, além de analisar as inúmeras alterações ocorridas pelo processo natural de envelhecimento. Considerações Finais: No Brasil a crescente população de pessoas idosas tem aumentado de forma vertiginosa. O CD deve situar-se a essas circunstâncias e amplificar suas compreensões na área da odontogeriatria para só assim assegurar um recurso terapêutico preciso, buscando sempre o conforto desses pacientes, já que eles necessitam de uma atenção mais especifica buscando precisão nos prognósticos e diagnósticos.

1130 Insomnia Short Sleep Phenotype is Associated With Frailty in Patients With Mild Cognitive Impairment (MCI)

Abstract Introduction Insomnia short sleep phenotype is associated with cardiometabolic morbidity and mortality and neuropsychological impairment. In elderly untreated insomnia is associated with worse cognitive performance. The goal of the study was to examine the association between insomnia, objective sleep duration and physical and mental health in elderly patients with Mild Cognitive Impairment (MCI). Methods A sub-sample of 105 patients with MCI (mean age: 75.9 years, males 36%) were recruited from a large population-based cohort (Cretan Aging Cohort) in the island of Crete, Greece of 3,140 elders (≥ 60yrs). All participants underwent a complete medical history/ physical examination, extensive neuropsychiatric and neuropsychological evaluation and 3-day 24hr actigraphy. Insomnia was defined based on a question “do you have insomnia for more than a year”. Frailty was assessed with the Simple “Frail” Questionnaire Screening Tool. Comparisons between patients with insomnia and without insomnia were made using ANOVA controlling for age, gender and BMI. Results MCI patients with insomnia (n=23) compared to those without insomnia (n=82), had significantly shorter objective total sleep time (TST: 377 vs. 410 min, p=0.05) and significantly higher scores on the Geriatric Depression Scale and the Hospital Anxiety Scale (both p &amp;lt;0.001). Furthermore, total frailty score, as well as scores in individual items, were significantly lower in MCI patients with insomnia (p&amp;lt;0.01). This association remained significant after controlling for demographics, depression and anxiety. Finally, there was a statistical trend of association between insomnia and hypertension (p= 0.1). Conclusion In MCI patients, insomnia is associated with objective short sleep duration, and frailty. Improving insomnia and lengthening sleep duration may decrease frailty, a major problem associated with morbidity, disability and mortality in elders with cognitive decline. Support National Strategic Reference Framework (ESPA) 2007-2013, Program: THALES, University of Crete, title: “A multi-disciplinary network for the study of Alzheimer’s Disease” (Grant: MIS 377299).