Öz
Amaç: Bir Geriatri merkezinde düzenli takip edilen hastaların sosyodemografik değişkenlerini, klinik durumlarını ve geriatrik sendromları değerlendirmek.
Gereç ve Yöntem: Geriatri polikliniğimizde Ocak 2013 ve Aralık 2015 yılları arasında düzenli takip edilen 1048 olgunun tıbbi kayıtları geriye dönük gözden geçirildi. Olguların yaş, cinsiyet, eğitim yılı, nörokognitif durum, duygu durum, günlük yaşam aktiviteleri, denge ve yürüme, nutrisyonel durumu da içeren Ayrıntılı Geriatrik Değerlendirme bilgileri, tanıları, kullanılan ilaç sayısı kaydedildi.
Bulgular: Olguların ortalama yaşı 77.4±6.8 olup %37.2’si erkek ve %62.8’i kadındı. %54.2’si evli ve %78.8’i en az 5 yıllık eğitime sahipti. 1048 olgunun %78.8’i non-demans olgularıydı ve %15.2’sinde Alzheimer hastalığı vardı. Olgularda polifarmasi (%59.8), üriner inkontinans (%44.1), ağrı (%41.8) ve uyku bozuklukları (%40.8) gibi geriatrik sendromlar bulunmaktaydı.
Sonuç: Yaşlı olgularda geriatrik sendromların değerlendirilmesi, hasta çıktılarının daha iyi olmasına neden olup, hastaların yaşam kalitesinin yükseltilmesi ve kişileştirilmiş tedavilere yardımcı olması bakımından önemlidir.
Kaynakça
- Charcot JM. Clinical lecture on senile and chronic diseases. London, New Sydenham Society,1881.
- Nascher IL. Geriatrics. N Y Med J 1909;90:358-9.
- Nascher IL. Geriatrics: The Diseases of Old Age and Their Treatment. Philadelphia, P. Blakiston’s Son&Co; 1914.
- Strasser DC. Geriatric rehabilitation: Perspectives from the United Kingdom. Arch Phys Med Rehabil 1992;73(6):582-6.
- Evans JG. Geriatric medicine: A brief history. BMJ 1997;315(7115):1075-8.
- Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: Clinical, research and policy implications of a core geriatric concept. J Am Geriatr Soc 2007;55(5):780-91.
- Arslantas D, Oezbabalik D, Metintas S, et al. Prevalence of dementia and associated risk factors in Middle Anatolia, Turkey. J Clin Neurosci 2009;16(11):1455-9.
- Barker WW, Luis CA, Kashuba A, et al. Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank. Alzheimer Dis Assoc Disord 2002;16(4):203-12.
- Mallet L, Spinewine A, Huang A. The challenge of managing drug interactions in elderly people. Lancet 2007;370(9582):185-91.
- Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007;5(4):345-51.
- Elmståhl S, Linder H. Polypharmacy and inappropriate drug use among older people: A systematic review. Healthy Aging Clin Care Elder 2013;5(1):1-8.
- Salazar JA, Poon I, Nair M. Clinical consequences of polypharmacy in the elderly: Expect the unexpected, think the unthinkable. Expert Opin Drug Saf 2007;6(6):695-704.
- Jyrkka J, Enlund H, Lavikainen P, Sulkava R, Hartikainen S. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf 2010;20(5):514-22.
- Fletcher PC, Berg K, Dalby DM, Hirdes JP. Risk factors for falling among community-based seniors. J Patient Saf 2009;5(2):61-6.
- Nuotio M, Jylha M, Luukkaala T, Tammela T. Health problems associated with lower urinary tract symptoms in older women. Scand J Prim Care 2005;23(4):209-14.
- Sergi G, De Rui M, Sarti S, Manzato E. Polypharmacy in the elderly: can comprehensive geriatric assessment reduce inappropriate medication use? Drugs Aging 2011;28(7):509-18.
- Lampela P, Hartikainen S, Lavikainen P, Sulkava R, Huupponen R. Effects of medication assessment as part of a comprehensive geriatric assessment on drug use over a 1-year period: a population-based intervention study. Drugs Aging 2010;27(6):507-21.
- Faltin DL. Epidemiology and definition of female urinary incontinence. J Gynecol Obstet Biol Reprod (Paris) 2009; 38(8 Suppl):146-52.
- Olmez N. Osteoarthritis. In: Isik AT, Mas RM, Karan MA, Grossberg GT (eds). New Horizons in the Geriatric Medicine. Volume 2. Nova Science Pub Inc; 2013: 246-90.
- Gloth FM III. Pain management in older adults: Prevention and treatment. J Am Geriatr Soc 2001;49(2):188-99.
- Ferrell BA, Ferrell BR, Osterweil D. Pain in the nursing home. J Am Geriatr Soc 1990;38(4):409-14.
- Tekin L, Ata E. Osteoartrit. In: Işık AT, Çelik T (eds). Geriatri Pratiğinde İlaç Tedavisi. 1. Baskı. İzmir: O’Tıp Kitabevi; 2015: 335-51.
- Roepke SK, Ancoli-Israel S. Sleep disorders in the elderly. Indian J Med Res 2010;131:302-10.
- Studenki S, Swearingen JV. Falls. In: Fillit HM, Rockwood K, Young J (eds). Brocklehurst's Textbook of Geriatric Medicine and Gerontology, 8th ed. Elseiver; 2017:864-72.
Öz
Materials and Methods: The medical records of 1048 patients who were regularly followed up in our geriatric outpatient clinic, between January 2013 and December 2015 were retrospectively reviewed. Age, gender, education year, diagnosis, number of drug used and data of compherensive geriatric assessment including neurocognitive status, mood, daily living activities, gait and balance, nutrition were recorded.
Results: The mean age of the cases was 77.4±6.8 of whom 37.2% were male and 62.8% female. 54.2% of them were married and 78.8% had education for at least 5 year. It was shown that 63% of 1048 patients were nondementia cases and 15.2% had Alzheimer’s disease. Geriatric syndromes such as polypharmacy (59.8%), urinary incontinence (44.1%), pain (41.8%), sleep disorders (40.8%) were found among the subjects.
Conclusion: Assessment of geriatric syndromes in the care of older patients are important to improve the quality of life significantly and help personalize management, leading to better patient outcomes.
Anahtar Kelimeler
Geriatric syndrome polypharmacy urinary incontinence pain sleep disorders falls
Kaynakça
- Charcot JM. Clinical lecture on senile and chronic diseases. London, New Sydenham Society,1881.
- Nascher IL. Geriatrics. N Y Med J 1909;90:358-9.
- Nascher IL. Geriatrics: The Diseases of Old Age and Their Treatment. Philadelphia, P. Blakiston’s Son&Co; 1914.
- Strasser DC. Geriatric rehabilitation: Perspectives from the United Kingdom. Arch Phys Med Rehabil 1992;73(6):582-6.
- Evans JG. Geriatric medicine: A brief history. BMJ 1997;315(7115):1075-8.
- Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: Clinical, research and policy implications of a core geriatric concept. J Am Geriatr Soc 2007;55(5):780-91.
- Arslantas D, Oezbabalik D, Metintas S, et al. Prevalence of dementia and associated risk factors in Middle Anatolia, Turkey. J Clin Neurosci 2009;16(11):1455-9.
- Barker WW, Luis CA, Kashuba A, et al. Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank. Alzheimer Dis Assoc Disord 2002;16(4):203-12.
- Mallet L, Spinewine A, Huang A. The challenge of managing drug interactions in elderly people. Lancet 2007;370(9582):185-91.
- Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007;5(4):345-51.
- Elmståhl S, Linder H. Polypharmacy and inappropriate drug use among older people: A systematic review. Healthy Aging Clin Care Elder 2013;5(1):1-8.
- Salazar JA, Poon I, Nair M. Clinical consequences of polypharmacy in the elderly: Expect the unexpected, think the unthinkable. Expert Opin Drug Saf 2007;6(6):695-704.
- Jyrkka J, Enlund H, Lavikainen P, Sulkava R, Hartikainen S. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf 2010;20(5):514-22.
- Fletcher PC, Berg K, Dalby DM, Hirdes JP. Risk factors for falling among community-based seniors. J Patient Saf 2009;5(2):61-6.
- Nuotio M, Jylha M, Luukkaala T, Tammela T. Health problems associated with lower urinary tract symptoms in older women. Scand J Prim Care 2005;23(4):209-14.
- Sergi G, De Rui M, Sarti S, Manzato E. Polypharmacy in the elderly: can comprehensive geriatric assessment reduce inappropriate medication use? Drugs Aging 2011;28(7):509-18.
- Lampela P, Hartikainen S, Lavikainen P, Sulkava R, Huupponen R. Effects of medication assessment as part of a comprehensive geriatric assessment on drug use over a 1-year period: a population-based intervention study. Drugs Aging 2010;27(6):507-21.
- Faltin DL. Epidemiology and definition of female urinary incontinence. J Gynecol Obstet Biol Reprod (Paris) 2009; 38(8 Suppl):146-52.
- Olmez N. Osteoarthritis. In: Isik AT, Mas RM, Karan MA, Grossberg GT (eds). New Horizons in the Geriatric Medicine. Volume 2. Nova Science Pub Inc; 2013: 246-90.
- Gloth FM III. Pain management in older adults: Prevention and treatment. J Am Geriatr Soc 2001;49(2):188-99.
- Ferrell BA, Ferrell BR, Osterweil D. Pain in the nursing home. J Am Geriatr Soc 1990;38(4):409-14.
- Tekin L, Ata E. Osteoartrit. In: Işık AT, Çelik T (eds). Geriatri Pratiğinde İlaç Tedavisi. 1. Baskı. İzmir: O’Tıp Kitabevi; 2015: 335-51.
- Roepke SK, Ancoli-Israel S. Sleep disorders in the elderly. Indian J Med Res 2010;131:302-10.
- Studenki S, Swearingen JV. Falls. In: Fillit HM, Rockwood K, Young J (eds). Brocklehurst's Textbook of Geriatric Medicine and Gerontology, 8th ed. Elseiver; 2017:864-72.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2018 |
| Gönderilme Tarihi | 28 Aralık 2016 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 57 Sayı: 1 |
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