Showing 25 results for Elderly
Ali A Jamebozorgi, Azam Kavoosi, Zahra Shafiee, Amir H Kahlaee, Mehdi Raei,
Volume 27, Issue 1 (2-2013)
Abstract
Background: Prevalence of fall-related mortality is rising in the elderly population. Falling is one of the causes of the murderous and non-murderous injuries in the elderly population which can lead to disability, dependence and decline of quality of life. Fractures constitute a major part of the fall-related injuries. The present study is designed to investigate the prevalence of fall-related risk factors of fractures in the Iranian elderly population. Methods: This descriptive study was performed on 240 elderly adults (aged 72.24±8.81 years) referred to Tehran hospitals in 2011 with wrist, femoral and proximal humeral fractures, using a questionnaire designed for this purpose.
Results: Ninety four (39.2%) cases were males and 146 (60.8%) were females. Slipping was the most prevalent mechanism of falling with the rate of 26.9% followed by falling from height and falling outdoors. Femur was the most frequently injured site (57.5%) while wrist and humerus were the next sites to be injured. Only 7.5% of the cases lived in a safe environment while in 37.2% and 55.2% cases, home environment was partly safe and non-safe, respectively. Conclusion: Fall-related fractures in the studied population is related to cardiovascular and musculoskeletal disorders, low level of physical activity and ignorance of safety principles but, the prevalence of neurologic diseases and drug and alcohol abuse, which have been mentioned as relevant risk factors in some studies, was very low in this population.
Afsun Nodehi-Moghadam, Morteza Taghipour, Razie Goghatin Alibazi, Hamzeh Baharlouei,
Volume 28, Issue 1 (1-2014)
Abstract
Background :Falls have been strongly associated with decreased physical activity and impaired mobility. Reduced range of motion, as a consequence of muscle stiffness, has been indicated to assume a positive relationship to fall incidence. Also clinical observations suggest that maintaining the normal spinal curves is associated with the prevention of spinal, knee and hip disorders. Thus, the aim of this study was to compare hip and ankle range of motions and thoracic and lumbar curves between young and old persons
Methods :Using a nonprobability sampling 30 elderly persons at average of 68.14 ±4.03 years of age and 30 young people (age 23.37 ± 2.31 years) through a case – control design participated in the study. Maximal hip extension and ankle dorsiflexion range of motions were measured by a standard goniometer. Thoracic and lumbar curvatures were measured by a flexible ruler in both groups. Independent t test were used to statistically analyze differences between groups.
Results :Compared with the young group, the elderly group had decreased hip extension and ankle dorsiflexion motions (p<0.01). The result of independent t test showed that the mean of lumbar curve was higher in young group (31.29± 6.37)than elderly subjects (27.93±8.11) ,however, no significant difference was found between two groups(p=0.08). The result also showed increasing thoracic curvature with aging (young group=34.43±13.27, old group= 36.19±8.97), however, no significant difference was found between two groups(p=0.55).
Conclusion :Findings suggest decreased ankle and hip joint range of motions should be considered in rehabilitation of elderly people.
Fatemeh Ehsani, Afsun Nodehi- Moghadam, Hakimeh Ghandali, Zahra Ahmadizade,
Volume 28, Issue 1 (1-2014)
Abstract
Background :Many studies have reported the increase in strength of the untrained contralateral limb after unilateral training. The aim of this study was to compare the cross education effect in the young and elderly persons.
Methods : In this quasi-experimental and pre-post study, 12 young people aged 28.25 ±3.11 years and 12 elderly persons (aged 73.08 ± 5.3 years) participated. The subjects had no history of strength training and upper limb movement impairments. Maximal isometric flexion strength in the dominant limb and the contralateral side before and after training were measured by tensiometer. Subjects performed elbow flexion exercises in the dominant side, using 3 sets of 10 repetition of the 60-70% maximal force for two weeks. Independent and paired t test were used to analyze between and within groups differences.
Results : The results showed that short-term isometric resistive exercise led to a significant increase of strength in trained and untrained limbs in both groups (p<0.05). There was not a significant difference between the two groups in the rate of strength increase, both in the upper limb that was exercised and also in the opposite side (p> 0.05).
Conclusion : The increased muscle strength observed during training indicates positive effect of training in old adult. The increased muscle strength in untrained limb suggests the capacity of neuromuscular adaptation among old adults, suitable to be used in cases of limb immobility or unilateral impairment.
Zahra Fotoukian, Farahnaz Mohammadi Shahboulaghi, Masoud Fallahi Khoshknab, Eesa Mohammadi, Hamid Reza Baradaran Attar Moghaddam,
Volume 28, Issue 1 (1-2014)
Abstract
Background: Empowerment of elderly people with chronic obstructive pulmonary disease (COPD) can increase their quality of life and feeling of well-being. However, few researches focused on the obstacles and factors facilitating empowerment in elderly people with COPD and an adequate determining of these factors need an in-depth understanding of the meaning of these factors which influences empowerment. The objective of this study was to explore the barriers to and factors facilitating empowerment in elderly people with COPD.
Methods : This study was conducted with a qualitative approach using content analysis. Twenty- four participants were selected based on purposeful sampling. Data were collected through conducting in-depth semi-structured interviews and making filed notes. Data analysis was performed according to the proposed steps by Granhym& Lund man (2004).
Results : The potential to empower the elderly with COPD was influenced by mediating factors the nature of aging, the difficult nature of COPD, fear and hopelessness, the cultural values and beliefs, poor formal support systems and poor economic status were found to be the barriers and incentive, trust to health care providers, the educable status of the elderly and increased experience were found to be facilitating factors.
Conclusion : It seems that empowerment of the elderly with COPD was affected by many factors which mainly rooted in social factors, health care systems and personal resources.
Elahe Shojaei, Hassan Ashayeri, Zahra Jafari, Mohammad Reza Zarrin Dast, Koorosh Kamali,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Speech perception ability depends on auditory and extra-auditory elements. The signal-to-noise ratio (SNR) is an extra-auditory element that has an effect on the ability to normally follow speech and maintain a conversation. Speech in noise perception difficulty is a common complaint of the elderly. In this study, the importance of SNR magnitude as an extra-auditory effect on speech perception in noise was examined in the elderly.
Methods: The speech perception in noise test (SPIN) was conducted on 25 elderly participants who had bilateral low–mid frequency normal hearing thresholds at three SNRs in the presence of ipsilateral white noise. These participants were selected by available sampling method. Cognitive screening was done using the Persian Mini Mental State Examination (MMSE) test.
Results: Independent T- test, ANNOVA and Pearson Correlation Index were used for statistical analysis. There was a significant difference in word discrimination scores at silence and at three SNRs in both ears (p≤0.047). Moreover, there was a significant difference in word discrimination scores for paired SNRs (0 and +5, 0 and +10, and +5 and +10 (p≤0.04)). No significant correlation was found between age and word recognition scores at silence and at three SNRs in both ears (p≥0.386).
Conclusion: Our results revealed that decreasing the signal level and increasing the competing noise considerably reduced the speech perception ability in normal hearing at low–mid thresholds in the elderly. These results support the critical role of SNRs for speech perception ability in the elderly. Furthermore, our results revealed that normal hearing elderly participants required compensatory strategies to maintain normal speech perception in challenging acoustic situations.
Salime Goharinezhad, Mohammadreza Maleki, Hamid Reza Baradaran, Hamid Ravaghi,
Volume 30, Issue 1 (1-2016)
Abstract
Background: The number of people aged 60 and older is increasing faster than other age groups worldwide. Iran will experience a sharp aging population increase in the next decades, and this will pose new challenges to the healthcare system. Since providing high quality aged-care services would be the major concern of the policymakers, this question arises that what types of aged care services should be organized in the coming 10 years? This protocol has been designed to develop a set of scenarios for the future of elderly care in Iran.
Methods: In this study, intuitive logics approach and Global Business Network (GBN) model were used to develop scenarios for elderly care in Iran. In terms of perspective, the scenarios in this approach are normative, qualitative with respect to methodology and deductive in constructing the process of scenarios. The three phases of GBN model are as follows: 1) Orientation: Identifying strategic levels, stakeholders, participants and time horizon; 2) Exploration: Identifying the driving forces and key uncertainties; 3) Synthesis: Defining the scenario logics and constructing scenario storyline.
Results: Presently, two phases are completed and the results will be published in mid-2016.
Conclusion: This study delivers a comprehensive framework for taking appropriate actions in providing care for the elderly in the future. Moreover, policy makers should specify and provide the full range of services for the elderly, and in doing so, the scenarios and key findings of this study could be of valuable help.
Sima Nedjat, Robab Sahaf, Hamid Reza Khankeh, Reza Fadayevatan, Reza Majdzadeh, Masoud Karimlou,
Volume 32, Issue 1 (2-2018)
Abstract
Background: The elderly population’s health has become a priority as their numbers are on the rise and they are increasingly becoming vulnerable to physical and mental diseases. Studies show that an elderly person’s health depends on his/her utilization of health knowledge in daily life. Hence, here we investigated the contributing factors of knowledge utilization in the elderly population.
Methods: A qualitative study was conducted through conventional content analysis. Semi-structured in-depth interviews were held with 29 elderly individuals from Tehran. A focus group discussion was conducted (eight elderly individuals), and an expert panel was held with nine experts to complement the results.
Results: Upon data analysis, four categories and seven subcategories were extracted. The main categories included provision of basic needs, maintaining dignity, life satisfaction, and negative feelings toward self and others. The concept of ‘life satisfaction’ held a pivotal role in relation to the other categories.
Conclusion: Life satisfaction was the main category in the utilization of health knowledge among the elderly. Aging should be foreseen and forethought to increase life satisfaction. The followings can be effective in increasing life satisfaction in the elderly: Promoting positive-thinking, placing greater emphasis on spiritualism in life, employment of the elderly, and promoting the culture and tradition of respecting the elderly.
Abolghasem Fallahzadeh Abarghuei, Mahsa Fadavi-Ghaffari, Safoura Tousi, Malek Amini, Ali Reza Salehi,
Volume 32, Issue 1 (2-2018)
Abstract
Background: One of the vulnerable populations of any community are the elderly, who are exposed to poor balance, falls, injuries, reduced quality of life (QoL) and independency, and early death. Considering the importance of balance in independently performing activities of daily living (ADL) and its impact on QoL, in this study, we aimed at investigating the effect of Cawthorne and Cooksey exercises (CCE) on QoL and balance of 60 to 80 year-old individuals in Shiraz, Iran.
Methods: This clinical trial study was conducted on forty 80 to 60-year-old individuals of Jahandideghan retirement center in Shiraz (20 in the intervention and 20 in the control groups) in 2014. The intervention group did CCE in three 60- minute sessions a week for 2 months. The balance status of the participants was assessed with Berg balance test, and their QoL was also examined using SF36 Quality of Life Questionnaire before the intervention and at 2 months post intervention. Data were analyzed by independent t test in SPSS software Version 19.
Results: The results of the study revealed that the difference was significant in the balance change scores between the 2 groups (p<0.001, effect size = 0.78). Change differences in the QoL scores were significant between the 2 groups as well (p<0.001, effect size = 0.39).
Conclusion: CCT improved QoL and balance of 60 to 80 year- old Shirazians, so considering the low cost, easy implementation, and considerable impact of the exercises, CCT could be used to prevent and treat balance disorders of the elderly.
Parvin Cheraghi, Zahra Cheraghi, Shiva Bozorgmehr,
Volume 32, Issue 1 (2-2018)
Abstract
Background: Osteoporosis is the most common metabolic bone disease and is a public health issue, particularly among the elderly, across the world. Given the significance of the disease in causing disability and, in particular, its dangers in old age, we aimed to examine osteoporosis and its determinant factors among the elderly.
Methods: We conducted a cross sectional study in the province of Hamadan from September 2015 to March 2016 on all the elderly men and women covered by ‘Integrated and Comprehensive Elderly Care Program’. The data required for this study was collected through an aging health care checklist. To estimate the adjusted association of potential risk factors and other confounding variables of osteoporosis, multiple logistic regression was used at a significance level of 5%.
Results: In this cross sectional study, 1779 elderly men and women aged 6o years and over were studied. The prevalence of osteoporosis was 7.99% (95%CI:7.79-8.18), which was higher among women than in men (8.08% vs. 7.83%). The factors that raised the probability of osteoporosis were as follow: aging (OR= 1.05, 95% CI: 1.02-1.07, p<0.001), low education (OR=1.96, 95% CI:1.02-3.84, p=0.04), living in urban areas (OR=2.82, 95% CI:1.93-4.11, p<0.001), smoking (OR=2.39, 95% CI:1.42-4.04, p<0.001), and family history of osteoporosis (OR=1.95, 95% CI:1.07-3.54, p=0.03).
Conclusion: Based on our results, aging, low education level, living in urban areas, being a cigarette smoker, and having a family history of osteoporosis were all predicting factors for osteoporosis among the elderly.
Farshad Sharifi, Mojde Mirarefin, Mahtab Alizadeh-Khoei, Neda Nazari, Baharak Najafi, Hossien Fakhrzadeh, Seyed Masoud Arzaghi, Ulrika Söderhamn, Fahimeh Taati, Neda Mehrdad,
Volume 32, Issue 1 (2-2018)
Abstract
Background: The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents.
Methods: Nursing home participant’s aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity.
Results: The Cronbach’s alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under-nutrition (cutoff=11) respectively.
Conclusion: The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.
Marzieh Pashmdarfard, Akram Azad,
Volume 34, Issue 1 (2-2020)
Abstract
Background: Given the increasing population of older adults in different societies, it is important to take into account the needs of them. In this regard, the most important things that are closely related to their quality of life are their ability in evaluating Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) performances. The aims of the present study were to identify the outcome measures specific to the ADL and IADL for older adults and to investigate the psychometric properties of these measures.
Methods: This is a systematic review done on the articles published between June 2019 and February 2019. Articles in English language from these database included: Medline, PubMed, Google Scholar, CINAHL, OVID Medline, Cochrane, ProQuest, Up to Date, Web of Science, OT search, OT direct, Pedro, SID, Magiran, Iran Medex, MEDLIB and Iran doc. English keywords included: “Activity of Daily Living (ADL)”, “Instrumental Activity of Daily Living (IADL)”, “assessment”, “evaluation”, “aging”, “ageing”, “older adults”, “elders”, “Basic Activity of Daily Living (BADL)”, “Advanced Activity of Daily Living (AADL)”, “basic functions”, “self-care”, “mobility”, “independency”, “dependency”, “occupational therapy”, “physical therapy”, “rehabilitation”. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist were employed to investigate the psychometric properties of the studies.
Results: Of the initial 482 studies considered, 13 studies met the inclusion criteria that assess the ADL and IADL performance of older adults. In this regard, 8 outcome measures were found especially for ADL assessment and 5 for IADL assessment.
Conclusion: Most of the assessment tools are performance-based and have been developed in especial contexts and especial groups of older adults. Some have been used frequently in different contexts but some were used less than others. None of these measures has been developed in Iran. So, for better assessment and having better intervention plans for older adults in Iran, it is suggested to develop an instrument that is especially designed for Iranian context.
Vahid Alipour, Zahra Meshkani, Aziz Rezapour, Ali Aboutorabi, Rafat Bagherzadeh, Naser Saber,
Volume 34, Issue 1 (2-2020)
Abstract
Background: In the coming years and near future, Iran will experience a main demographic transition resulting in an aging phenomenon and increased number of people over 65 years. Aging leads to increased medical expenditures associated with chronic diseases such as osteoporosis. This study aimed to investigate the patient-specific hospitalization costs of osteoporosis treatment in elderly patients.
Methods: A retrospective cost analysis of hospitalization arising from osteoporosis conducted on all the elderly patients (adults aged 65 years and above) in a teaching hospital in Tehran through examining hospital admissions during 2017. The elderly patients consisted of 295 with a length of stay ≥ 24 hours. Cost analysis was performed using a bottom-up micro-costing approach and payer perspective (patient and insurer); and the result was statistically significant (p≤0.05). Nonparametric tests, including Mann–Whitney and Kruskal–Wallis tests, were used to investigate the relationship between affecting variables. Hospital training was considered as a control variable. The data were analyzed using SPSS 11 software
Results: The mean age of the patients was 71.3 years; of the patients, 79% were female and 21% male. The overall crude prevalence of osteoporosis was 80% among people ≥ 65 years and 85% among patients who experienced relevant surgeries. The average cost of hospitalization was $3794.13. Also, 3 main areas of hospital costs were identified: consumables (57.70%), hoteling (17.24%), and surgical services (15.76%). The prevalence of osteoporosis was 4 times higher in women compared with men. Moreover, there were significant differences between the variables affecting hospital costs, such as gender, length of stay, diagnosis, intensive care unit services, and surgery (p<0.05).
Conclusion: Age-associated diseases such as osteoporosis increase the health care costs. The dominant cost drivers in this study were the consumables, hoteling, and surgical services, respectively. Policymakers and health care planners should consider such variables as gender, previous surgeries in the patients’ records, length of stay, and intensive care unit services as driving factors and determinants of hospital costs for older seniors with osteoporosis.
Masoumeh Mohamadi, Azadeh Goodarzi, Armin Aryannejad, Nima Fattahi, Mahtab Alizadeh-Khoei, Shahnaz Miri, Hamidreza Hekmat, Moloud Payab, Mohammad Bodaghabadi,
Volume 34, Issue 1 (2-2020)
Abstract
Background: During the COVID-19 pandemic, elderly individuals (with the chronological age of 65 years and above) are more susceptible to the SARS-CoV-2 infection complications due to altered immune system response and the higher rate of underlying comorbidities. A vast majority of mortalities are reported in elderly patients; thus, this study aimed to evaluate complications of COVID-19 in elderly patients.
Methods: A systematic review was conducted according to MOOSE guidelines. Science Direct, Google Scholar, Scopus, PubMed databases were searched for published articles related to COVID-19 in the elderly up to March 26, 2020. Search MeSh terms included "Severe acute respiratory syndrome coronavirus 2", "2019-nCoV", "SARS-CoV-2", "comorbidity", "elderly", and "geriatrics".
Results: In total 1360 potentially relevant articles were screened, of which 35 were relevant and their full texts were considered for the review. Organ damages to the pulmonary system, cardiovascular, liver, and renal system are more prevalent in the elderly with SARS-CoV-2 infection. As the chance of multiorgan involvement is more common among elderly patients, preventive, multidisciplinary, and holistic evaluations are essential to reduce disease consequences.
Conclusion: More attention needs to be paid to elderly individuals in the quarantine. Social contact should be made and maintained through online facilities, media, and phone calls to ensure patients’ mental health during this stressful situation. Also, they should be provided with enough food and medications by their families or friends. Also, providing social and volunteer services might play an important role in the mental health of those patients who have no social network.
Arezoo Orooji, Eisa Nazar, Masoumeh Sadeghi, Ali Moradi, Zahra Jafari, Habibollah Esmaily,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Aging is a major challenge not only for high-income countries but also for middle- and low-income countries. The length of stay (LOS) in hospitals is one of the major concerns of elderly patients, which should be taken into consideration. We aimed to investigate the factors affecting LOS of elderly patients admitted to a referral hospital of northeast of Iran.
Methods: A relatively large population of 7130 hospitalized elderly patients (over 65 years old) who referred to Ghaem hospital (Mashhad, Iran) from March 20, 2016 to March 19, 2017 were selected. The demographic and medical records data of patients were extracted from the hospital database. Univariate analyses as well as count regression models, including poisson regression and negative binomial regression, were conducted to assess the influential factors on the LOS and the number of admissions considered for potential confounders using SAS software. In this study α =0.05 was considered as statistically significant.
Results: The mean age of participants was 76.57±7.29 years, and 54.8% were male and 45.2% were female. The mean LOS was 8.11±13.97 days and the mean number of admissions 1.5±1.73 times. The negative binomial regression model had better fitness than Poisson's model. Findings indicated that emergency hospitalization (RR: 0.21), admission to the CCU (RR: 0.33), and male gender (RR: 0.92) were statistically reducing factors for LOS among elderly patients, respectively. Discharge status (deceased, RR: 1.50), patients with diagnosis of injuries and poisoning (RR: 1.34), and native residence (RR: 1.10) were factors that statistically increased the length of stay among hospitalized elderly patients.
Conclusion: LOS in hospitals is affected by multiple factors and the negative binomial regression model is a better statistical method for estimating the influencing factors.
Saiedeh Bahrampouri, Hamid Reza Khankeh, Seyed Ali Hosseini, Mohammadreza Mehmandar, Abbas Ebadi,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Iran will face the "aging Tsunami" phenomenon by the 2040s. Therefore, paying attention to the elderly's driving to maintain and promote their independence and quality of life on the one hand and paying attention to the dangers of driving by the elderly for road safety will be important. The purpose of this research was to determine the components of driving competency in the elderly.
Methods: The research has employed a scoping review. To this end, searches of scientific databases were conducted using keywords between 1990 and 2019. The process of selecting the documentation was-based on the PRISMA chart.
Results: In the first phase, 2769 records were found, and finally, 37 records met the inclusion criteria set for this study. The results indicated that 18 components were extracted that were classified into seven main categories including cognitive, sensory, motor, mental functions, and medications, diseases, and driving history.
Conclusion: Sensory, motor, and cognitive abilities are the most important components of elderly safe driving. Therefore, as age increases, chronic disease, multiple drug use, and subsequent problems increase. This can affect the ability to drive safely and can cause traffic injuries. Therefore, it is recommended to use the results of this research to design a suitable tool and model for assessing driving competency in the elderly.
Salah Eddin Karimi, Nasibeh Zanjari, Neda Soleimanvandiazar, Elaheh Ahounbar, Mohammad Ali Mohammadi Gharehghani, Mohammad Ali Ahmadi,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Injection of drugs is one of the most serious health problems among Iranian living with HIV/AIDS. The injection of drugs, accounting for the transmission of more than two-thirds of HIV infections. HIV remains a major concern around the world and is expected to be the third leading cause of mortality worldwide. Thus, the aim of this study was to explore the predictors of injection drug use in the elderly patients living with HIV/AIDS.
Methods: This was a cross-sectional study executed in Tehran City, Iran, in 2018. A total of 160 individuals aged 60 years and older with HIV from different counseling centers were selected by convenience sampling. Data were collected using questionnaires including a positive state of mind, coping, social support, and a checklist of demographical variables. Bivariate analysis and multiple logistic regression using SPSS software version 21.0 were employed to determine factors associated with drug injection. The statistical tests were performed with a significance level of 5% (p≥0.05).
Results: The study participants’ mean(SD) age was 65.6(±6.6) years. In total, 33 people (20.6%) of the samples reported injection drug use. The frequency of injection drug use was greater among men (AOR: 2.28, 95% CI 2.2-22.8; p=0.010), those reporting a monthly income of ≥30000000 Rials (AOR: 31.56, 95% CI 2.95-338; p=0.004), subjects with past experience of drug use (AOR: 7.11, 95% CI 2.18-23.2; p=0.001), those with ≥2 years past from their HIV diagnosis (AOR: 4.04, 95% CI 1.12-14.58; p=0.033), and those living with more than two people in one residential place (Household size AOR: 5.9, 95% CI 1.64-21.24; p=0.007).
Conclusion: It seems that the design and implementation of harm reduction programs among the elderly with HIV/AIDS who inject drugs are essential and should be considered as an agenda of policymakers and health professionals.
Ali Reza Kalantari, Mohammad Hossein Mehrolhassani, Mohsen Shati, Reza Dehnavieh,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Current Health care delivery systems are not effective for the elderly. Countries with high elderly populations are expected to design special models to serve their elderly population. The aim of this study is to investigate the models of health care delivery to the elderly in different countries.
Methods: The present study is a systematic review based on PRISMA standard guidelines. The search for related studies was conducted in electronic databases (Cochran Library, Scopus, PubMed, Embase, Web of Science) and the Google Scholar search engine without time limits until May 2019. Keywords were extracted based on MeSH strategies. At first, 16243 articles were found. After the screening phase (elimination of duplicated articles, title screening, abstract screening, and full-text screening) 19 articles remained. Two articles deleted after text appraisal using the CASP checklist. In the next stage, after reviewing the gray literature and reviewing the references of remaining articles, three new articles were added (Included studies = 20).
Results: Twenty articles (models) corresponding to the study objectives were finally extracted. These models are limited to nine countries and most have local scopes. These models mainly use a case manager, an intra- or inter-disciplinary team, and an elderly assessment tool in their structure. In addition to the use of an information system, these models provide a wide range of services to the elderly.
Conclusion: Most of the models mentioned are local models. Smaller models to become applicable at the national level, they need to be reviewed and evaluated by policymakers and experts. Given the inefficiency of current systems in providing services to the elderly, it is recommended that countries use an integrated model of health care provision for the elderly.
Hakimeh Afaghi, Farshad Sharifi, Mitra Moodi, Gholamreza Ananisarab, Tooba Kazemi, Ebrahim Miri-Moghaddam, Zoya Tahergorabi,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Anemia is a multifactorial and common public health problem in geriatric age groups, especially in developing countries. Therefore, this study was designed to study the prevalence of anemia and associated factors among the elderly population in Birjand, Iran, in 2019.
Methods: This was a cross-sectional approach to the baseline data of the Birjand longitudinal aging study (BLAS) in which 1396 people aged ≥ 60 years were screened for the presence of anemia based on the World Health Organization (WHO) criteria. For each participant, a standard questionnaire was administered. Furthermore, the height, weight, and body mass index (BMI) were calculated. Blood samples were obtained from each participant for hematological examination. Hemoglobin, hematocrit, and other indices of cell blood count were measured using an automatic cell counter. The prevalence rates were estimated using survey analysis with the weight of Birjand county older population. Univariate and multivariable logistic regression analyses were applied to detect the associated factor with anemia.
Results: The mean age of the participants was 69.73±7.66 years. The crude prevalence of anemia was 11.10%, and the age-standardized prevalence based on the standard WHO population 2000-2025 was equal to 16.78% (12.81%–21.66%) (15.95% [10.41%–23.69%] in women and 17.32% (12.65%–23.25%) in men. Mild and normocytic anemia were the predominant types. The mean hemoglobin, hematocrit, mean cell volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were lower in women than in men and the mean platelet count in women was higher (p<0.001). In the final multivariate logistic regression model, only age groups, BMI, fish consumption, and chronic kidney disease (CKD) were related to anemia.
Conclusion: In conclusion, our findings showed the association of anemia with some risk factors and diseases. Anemia in geriatric age groups is often underdiagnosed; hence, identification of subgroups at risk for anemia and its associated risk factors in geriatric groups has a paramount importance in preventing adverse outcomes.
Abdoulreza Esteghamati, Ali Nazari-Alam, Ali Badamchi, Mahmood Faramarzi, Mehri Naghdalipour, Ali Baradaran Moghadam, Khadijeh Khanaliha, Ahmad Tavakoli, Mohammad Rahbar, Zeinab Fagheei Aghmiyuni, Shirin Sayyahfar,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Infections caused by Streptococcus pneumoniae (S. pneumoniae) have remained a significant public health concern worldwide. In developed countries, the highest prevalence of S. pneumonia has been reported among the elderly. The aim of this study was to evaluate the coverage of genotypes in the 13-valent pneumococcal conjugate vaccine (PCV-13) in the Iranian elderly population.
Methods: A total of 41 isolates of S. pneumoniae were collected in the current retrospective cross-sectional study. The samples comprised 33 inpatients hospitalized for pneumococcal pneumonia and 8 outpatients. Multiplex polymerase chain reaction assay was performed to categorize the bacteria isolated into specific genotypes. Statistical analyses were performed using SPSS software, and the chi-square test was used to assess the statistical significance in percentages.
Results: A total of 68 genotypes were identified in this study, in which 39 isolates (57.3%) were associated with invasive infections. The most common genotypes were 6A/B [8 (19.5%)], 1 [7 (17.5%)], 14 [5 (12.2%)], and 19A [4 (9.75%)], respectively. The coverage rates of PCV-7, PCV-10, and PCV-13 vaccines were 51.17%, 70.7%, and 99.9%, respectively. According to our results, the pneumococcal coverage rate of PCV-7, PCV-10, and PCV-13 vaccine types is estimated to be 51.2%, 70.7%, and 99.9%, respectively. Furthermore, the trend of pneumococcal serotypes included in the PCV-13 was steadily increasing during the study period.
Conclusion: It can be concluded that the most circulating pneumococcal serotypes were in accordance with specific serotypes included in the PCV-13 vaccine types. Therefore, including PCV-13 vaccines in immunization programs against pneumococcus in the elderly can effectively reduce the rate of infections.
Maryam Safarnavadeh, Mahin Ghanbari, Leili Salehi,
Volume 37, Issue 1 (2-2023)
Abstract
Background: There are considerable documents suggesting that inadequate fiber intake (FI) is a key risk factor for various chronic diseases. The aim of this study was to investigate Dietary FI in the Persian elderly.
Methods: This descriptive-analytic study was performed to investigate FI in a sample of the elderly who received free services from healthcare centers in Karaj, Iran. For sampling method: at first, the names of 36 centers were written on small pieces of paper and poured into a container, then another person was asked to randomly select the names of 10 centers, then referring to each of the centers and preparing a list of elderly people, the study subjects were selected, The study was conducted between September 2018, and April 2019Several questionnaires were used to collect data regarding DF: characteristics, daily FI , knowledge, SE (self-efficacy), perceived benefits, and barriers towards FI as well as stage of readiness of FI. t-test and ANOVA were used to compare independent mean values. Data were checked for normality before analysis by using Kolmogorov-Smirnov (K-S) test to check data normality.
Results: Totally of 400 elderly individuals entered the study with the average amount of fiber per day. The data analysis indicated they did not know the recommended intake of at least 25 gr each day. feeling less hungry and fiber’s price was the most frequent perceived benefits and barriers towards FI , respectively. Gastrointestinal diseases (P < 0.001), smoking (P < 0.001), and perceived barriers (P < 0.001), were statistically significant independent positive predictors of FI.
Conclusion: The findings of the current study indicated that FI among elderly people in Iran was very low and varied a great by gender, education, marital status, income level, employment status, smoking, stage of change, and gastrointestinal disease.
