Nongeriatric Groups Research Articles

English

BACKGROUND: Drug utilization studies conducted at regular intervals help to guide the physician in prescribing drugs rationally. OBJECTIVE: The objective of the present study was to assess the drug utilization patterns of antihypertensive in geriatric and non-geriatric patients in a tertiary care government teaching hospital. METHODS: A prospective cross sectional study was conducted in a tertiary care government teaching hospital. Data was collected from patients who have been diagnosed with hypertension as per JNC-7 guidelines and patients receiving or prescribed with antihypertensive medications were included. Frequency and proportions of utilization of antihypertensive medications in geriatric and Non-geriatric patients were charted and figured. RESULTS: A total of 226 prescriptions were analyzed during the three month study period. The most common medication prescribed for hypertension in the study was ARBs 27.77%, 34.37% in Geriatric and Non-geriatric patients respectively. The ARBs prescribed pattern was followed by ACEIs and CCBs. The most frequently prescribed anti-hypertensive fixed dose combination therapy was ARB+D, ACEI+D followed by CCB+BB in both Geriatric and Non-geriatric groups. CONCLUSION: The present study showed that the prescription pattern of antihypertensive was based upon the duration, severity of illness and the associated co-morbidities, it does not depend on the age of the patients.

Comorbidities and complications influence the diagnosis and management of geriatric supraglottitis

IntroductionThis study aimed to assess the differences in the clinical characteristics, management, and outcomes of supraglottitis between geriatric and nongeriatric adults over a 30-month period. MethodsAll adult patients admitted to the emergency department with suspected supraglottitis and who underwent laryngoscopy for confirmation were included. We collected the clinical characteristics, management, and outcomes of these patients and compared geriatric (≥60 years old) and nongeriatric (12-59 years old) groups in terms of these data. ResultsEighty-one geriatric patients and 205 nongeriatric patients were reviewed during the study period. The accuracies of the clinical suspicions of supraglottitis were lower in the geriatric group (geriatric vs nongeriatric, 29.4% vs 47.3%, P = .008). The geriatric group constituted 19.8% of all supraglottitis patients. Comorbidities were discovered in 74.1% of the geriatric group and 25.4% of the nongeriatric group (P = .000). The complication rate in the geriatric patients was almost twice that of the nongeriatric patients (20.8% vs 10.8%). Additionally, the geriatric patients exhibited tendencies toward longer periods of intubation, hospitalization, and stay in the intensive care unit. ConclusionsThe clinical characteristics and management were similar between the geriatric and nongeriatric supraglottitis patients. Nevertheless, the comorbidities altered the clinical presentations of the geriatric patients and resulted in lower diagnostic accuracy. Additionally, the elevated complication rates of the geriatric patient might have negatively affected their outcomes.

Psychological Impact of the Tsunami on Elderly Survivors

The study aimed at comparing the psychiatric morbidity in geriatric versus nongeriatric (NG) adults during the initial 3 months following the December 2004 tsunami involving the Andaman and Nicobar Islands, India. This observational study was undertaken during the relief operation of tsunami. There were 12,784 survivors sheltered across 74 relief camps with 4,684 displaced survivors in Port Blair, and 8,100 nondisplaced survivors in Car Nicobar Island. All persons who accessed mental health assistance within the camps constituted the study sample. Diagnoses were made by qualified psychiatrists using the International Classification of Diseases, Tenth Revision. There were 438 adult patients, of which 75 (17%) were geriatric (60 years or older) and 363 (83%) were NG (aged 19-59 years). The geriatric sample had greater levels of adjustment disorder than NG group. The two groups differed in terms of displacement as the elderly preferred to stay in their own locality. A comparison between displaced geriatric and NG groups showed that major depression was less common in the geriatric sample. However, in the nondisplaced group, geriatric subgroup showed a higher incidence of posttraumatic stress disorder. Within the geriatric sample, there were higher levels of adjustment disorder in the nondisplaced group whereas the displaced group suffered more depressive episodes and unspecified anxiety disorders. Greater levels of adjustment disorder in geriatric group may indicate grief reaction and survivor guilt, especially in nondisplaced group. In addition, lower occurrences of depressive episodes in nondisplaced geriatric sample may indicate that the elderly need to be rehabilitated in their own habitats after major disasters.

The Effect of Providing Power Mobility on Body Weight Change

To investigate whether the provision of power mobility would have an effect on body weight in adults who were first-time qualifiers for power mobility. This was a retrospective observational study of consecutive subjects, who served as their own controls. The medical records of 468 subjects who were approved for power mobility during a 17-mo period were reviewed. Three weight groups (12 mos before, at, and 12 mos after the power mobility evaluation) were evaluated with repeated-measures analysis of variance (ANOVA). The weight changes on subjects in different age groups (45-54, 55-64, 65-74, and >74), in geriatric vs. nongeriatric groups, and in different body mass index (BMI) groups were analyzed. Eighty-nine subjects met the inclusion criteria. They were obese (49.4%), and most of them were geriatric (64%). Congestive heart failure (30.34%) and chronic obstructive pulmonary disease (22.47%) were the two main presenting diagnoses. The repeated-measures ANOVA showed no significant weight change in the three studied weight groups. Similar results were seen in the age and BMI subgroups. There was no statistically significant weight change in adults who were first-time qualifiers and who used power mobility for 1 yr.

Poster 49: Acute rehabilitation of the geriatric patient: sociocultural, clinical, and functional characteristics with implications

Objectives: To define the sociodemographics, clinical, and functional characteristics of the Singapore population and to discuss the implications. Design: A database review of patients defined as geriatric (age >64y) compared with the nongeriatric patients. Setting: Rehabilitation unit. Participants: 172 (46%) of 374 consecutively admitted patients. Interventions: Not applicable. Main Outcome Measure: FIM™ instrument. Results: 87 (51%) of the geriatric group were men and stroke (64.5%) was the most common primary diagnosis. 39 patients (22.6%) had depression, and urinary tract infection (UTI) was the most common (n=36, 20.1%) medical complication. Comparing the geriatric and nongeriatric groups, no significant differences were found in the rehabilitation length of stay ( P=.41). In the geriatric group, the mean admission FIM score was 65 while the final FIM score was 84.1 and these were lower than the corresponding scores for the nongeriatric group (admission FIM=70.2, P=.03; discharge FIM=90.4, P=.008). However, there were no differences in the quantum of improvement of the FIM scores ( P=.45) between the 2 groups. 24 geriatric patients (14%) had no ready caregiver. Most geriatric patients (90.1%) were discharged home and outpatient therapies were arranged for most (80%). Conclusions: About half of our patients were geriatric, and good functional gains were achieved compared with the nongeriatric patients. Depression and UTI are common and vigilance should be maintained in detecting and treating these. A home disposition is an achievable goal and discharge planning should consider options if no caregiver is available. Outpatient therapies should remain affordable and accessible.

Frontal lobe functioning in geriatric and non-geriatric samples: An argument for multimodal analyses

The present investigation examines specific aspects of frontal functioning across geriatric and nongeriatric cohorts. Subjects included 193 nongeriatric male pilots (mean age: 48.29 (SD = 6.79); mean education: 15.93 years (SD = 1.86)), and 68 geriatric males and females (mean age: 78.38 (SD = 5.07); mean education: 13.68 (SD = 2.53)). The results of a series of general linear model multivariate one-way analyses revealed poorer performance on frontal measures in the geriatric sample, although no differences were noted between the male and female samples. In contrast, variable interrelations, as assessed by a parametric statistic of betweengroup factor similarity, indicated a noteworthy similarity of factors between the geriatric and nongeriatric groups, and dissimilarities between the factor structures for males and geriatric females. These findings not only support the presence of age-related differences in frontal performance for the domains tested, they suggest the need to examine frontal functioning by multiple methods, as differences in frontal functioning may exist between groups that are undetected by analyses based on intergroup score differences or predictor-criterion correlations alone

The Treatment of Pain in the Elderly Patient. The use of Oral Morphine in the Treatment of Pain.

These reports concern 117 elderly patients suffering from cancerous pain and demonstrate the efficacy of oral morphine treatment, more often associated with adjuvants. The score relief is good. The frequent side effects have been in the most cases rapidly controlled by appropriate measures. Being old is not an obstacle for a safe and efficient analgesic treatment. The useful dosage of morphine, the scores of relief, and the frequency of side effects are comparable to those observed in non-geriatric groups.

Studies of Body Image. IV. Figure Drawings in Normal and Abnormal Geriatric and Nongeriatric Groups

Figure drawings were obtained from 72 normal adults, 48 adult psychiatric inpatients, 30 senior citizens, and 33 elderly inpatients in a mental hospital. Blind analyses were carried out for "emotional indicators" and other characteristics such as body image disturbance and intellectual impairment. Significant differences were found on almost all measures between the normal elderly and the normal adult. They were also found to discriminate between the normal adult group and the adult psychiatric patients. Very few differences were found between the normal elderly and elderly psychiatric patients, or between normal elderly and adult psychiatric patients. These results imply that norms based upon figure drawings of children or adults may not apply to the elderly and that, therefore, figure drawings may be a less useful diagnostic tool for elderly people than they are for children or adults.