EGYPT - AGEING POPULATION
Hala
Sweed
Geriatrics and Gerontology Department,Faculty of Medicine- Ain Shams University
author
Manar
Maemon
Geriatrics and Gerontology Department,Faculty of Medicine- Ain Shams University
author
text
article
2014
eng
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
1
9
https://ejgg.journals.ekb.eg/article_5330_91475a5e3de06bf97c85610b30019a96.pdf
dx.doi.org/10.21608/ejgg.2014.5330
Admission predictors of mortality in Geriatrics intensive care
Mahmoud
Refaee
Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
Doha
Rasheedy
Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
text
article
2014
eng
Background: Elderly patients are a significant and increasing proportion of ICU patients. With advancing age, the comorbidities critically ill elderly patients have substantial mortality. The early recognition of patients at high risk of mortality is needed to plan care in advance and to control healthcare costs. Aim: To find out the admission clinical and laboratory predictors of mortality in critically ill elderly admitted to ICU. Method: A prospective study was performed in Geriatric ICU in Ain Shams University Hospitals including 90 critically ill elderly patients admitted for 24 hours or more. Each patient was subjected to on admission clinical assessment, in addition to laboratory investigations including; measurement of serum levels of Blood urea Nitrogen, Creatinine, Sodium, Potassium, Calcium, Phosphorus, Magnesium, Zinc, Bilirubin, Complete blood count (CBC), CRP and arterial blood gases. Results: Mortality accounted for 39% of patient‘s outcome. Advanced age was significantly associated with increased mortality (p=0.03) The acute stroke as a cause of admission was found to be associated with increased mortality (P= 0.00). Length of ICU stay and the use of mechanical ventilation significantly increased mortality (P= 0.01, P = 0.000) respectively. Tachycardia, tachypnea and deep coma were also found to be associated with increased mortality (P= 0.003, 0.02, 0.000) respectively. Hematocrit, bicarbonate, and sodium levels were significantly lower among the non survivors. Conclusions: The most important factors independently associated with the high risk of mortality among elderly admitted in ICU are; advanced age, impaired level of consciousness, need for mechanical ventilation, low serum sodium and bicarbonate levels. Early management of hyponatremia and metabolic acidosis is substantial for improving outcome in geriatric ICU.
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
10
17
https://ejgg.journals.ekb.eg/article_5331_4e17b48049717a293f5ec7d8056583b0.pdf
dx.doi.org/10.21608/ejgg.2014.5331
Highlights on Diabetes Mellitus in Older Adults
Shereen
Mousa
Geriatrics & Gerontology Department, Faculty of Medicine, Ain Shams University
author
text
article
2014
eng
It is estimated that by the year 2030, there will be 8.6 million adults with diabetes in Egypt, making it the country with the tenth largest population of diabetics in the world [1]. The prevalence of diabetes rises dramatically with age in both sexes; it reaches almost 20% among females aged 50-59 [2]. The burden of diabetes in adults is often described in terms of its impact on working-age, while in older adults it is linked to decreased functional status, institutionalization, and mortality [3]. Older persons and/or those with multiple comorbidities have often been excluded from randomized controlled trials of treatment despite having the highest prevalence of diabetes [4].
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
18
20
https://ejgg.journals.ekb.eg/article_5332_3d84f2b27cef906a565e002adab949a5.pdf
dx.doi.org/10.21608/ejgg.2014.5332
Vitamin D and Geriatric syndromes: Possible links
Samia
Abdul-Rahman
Geriatric and Gerontology department, Ain Shams University, Cairo, Egypt.
author
text
article
2014
eng
Background: Vitamin D deficiency is a very common problem among elderly population. Extra-skeletal functions of vitamin D are an interesting new area of research since the discovery of vitamin D receptors in different extra-skeletal organs and possible links to common geriatric syndromes and problems have been examined. This presentation reviews current knowledge regarding vitamin D possible links to common geriatric syndromes.
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
18
20
https://ejgg.journals.ekb.eg/article_5333_126297f461d62da58c3f90a231147d9f.pdf
dx.doi.org/10.21608/ejgg.2014.5333
Luteinizing Hormone in Frail Elderly Individuals
Salma
EL Said
Departments of Geriatrics,Faculty of Medicine-Ain Shams University
author
Somaia
Ebeid
Departments of Geriatrics,Faculty of Medicine-Ain Shams University
author
Manar.
Mamoun
Departments of Geriatrics,Faculty of Medicine-Ain Shams University
author
Hala.
Sweed
Departments of Geriatrics,Faculty of Medicine-Ain Shams University
author
Karim
Shaheen
Clinical Pathology,Faculty of Medicine-Ain Shams University
author
Mohamed
Elbanouby
Departments of Geriatrics,Faculty of Medicine-Ain Shams University
author
text
article
1999
eng
Background: The term "frailty" has been used clinically as a global concept to describe a condition, common in the old, of impaired strength, endurance, and balance, vulnerability to trauma and other stressors, and high risk for morbidity, disability, and mortality. A variety of factors may contribute to frailty or to one or more of its specific features. These include inflammatory, musculoskeletal, cardio respiratory, metabolic, hematologic, neurologic, immunologic and endocrine factors. Hormones important to the development of frailty that has been proposed include testosterone, luteinizing hormone (LH) and dehydroepiandrosterone (DHEA). Objective: to study the association between LH level and frailty among the elderly Method: A case control study was carried out. The case group included 80 Frail elderly subjects selected according to the American Geriatric Society Criteria; whereas 80 non-Frail elderly subjects were selected as the control group. Each participant was subjected to Comprehensive Geriatric Assessment and laboratory assessment of luteinizing hormone. Results: LH level was lower in frail subjects compared to non frail. Lower levels were significantly correlated with increased degree of dependency in both frail males and females. Conclusion: Luteinizing hormone level was lower among frail elderly. Further studies are needed to confirm such an association and to plan clinical practice accordingly.
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
1999
https://ejgg.journals.ekb.eg/article_5334_bb81afdb348eb58ce9d70fa396b18b57.pdf
dx.doi.org/10.21608/ejgg.2014.5334
Modes of intra-articular injection of Mesenchymal Stem Cells for treatment of Osteoarthritis
Salma M.S.El Said
El Said
Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2014
eng
Despite the high prevalence and morbidity of osteoarthritis (OA), an effective treatment for this disease is currently lacking. Restoration of the diseased articular cartilage in patients with OA is, therefore, a challenge of considerable appeal to researchers and clinicians. Techniques that cause multipotent adult mesenchymal stem cells (MSCs) to differentiate into cells of the chondrogenic lineage have led to a variety of experimental strategies to investigate whether MSCs instead of chondrocytes can be used for the regeneration and maintenance of articular cartilage. MSC-based strategies should provide practical advantages for the patient with OA. These strategies include use of MSCs as progenitor cells to engineer cartilage implants that can be used to repair chondral and osteochondral lesions. Delivery of MSCs might be attained by direct intra-articular injection or by graft of engineered constructs derived from cell-seeded scaffolds. Promising experimental and clinical data are beginning to emerge in support of the use of MSCs for regenerative applications
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
35
40
https://ejgg.journals.ekb.eg/article_5335_56f4a3a71625613e902ef67a06db39d1.pdf
dx.doi.org/10.21608/ejgg.2014.5335
Pattern of Symptomatic Idiopathic Osteoarthritis In Elderly: A Hospital Based Study.
Mohamed
El-Banouby
Geriatrics and Gerontology department, Faculty of Medicine, Ain Shams University,
author
Mohamed
Zaki
Physical Medicine, Rheumatology and Rehabilitation department, Faculty of Medicine, Ain Shams University
author
Sarah
Hamza
Geriatrics and Gerontology department, Faculty of Medicine, Ain Shams University
author
Nermien
Adlya
Geriatrics and Gerontology department, Faculty of Medicine, Ain Shams University
author
text
article
2014
eng
Objectives: to assess pattern of symptomatic idiopathic OA in the elderly and the possible risk factors in that group of patients. Subjects and methods: A cross sectional study was conducted among 100 patients aged ≥ 60 years from Ain Shams University hospital, each patient was subjected to comprehensive geriatric assessment. Hip, hand, and knee OA were diagnosed by American College of Rheumatology criteria, and 1st metatarso-phalangeal , talonavicular, wrist joints, lumbar apophyseal joints and cervical apophyseal joints were diagnosed by presence of any of clinical manifestations plus Kellgren and Lawrence grading (≥ grade 2). Risk factors were reported by history, examination and occupational exposure questionnaire. Results: Knee, hip and hand OA were present in 80%, 23% and 30% consecutively. 38% were obese and 12% were smoker. Seventy one percent were at risk of carrying heavy objects. Females have significantly more knee, hand, wrist, cervical and foot OA than males. Females were more obese and less smoker (P= 0.002 and ˂0.001 consecutively). Conclusion: Females have overall and individualized sites (including: knee, hand, wrist, cervical and foot) OA more than males, and higher risk factors than males (including BMI and repeating the same movement in many sites).
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
41
52
https://ejgg.journals.ekb.eg/article_5336_6b65b2db986a21e031757bb381dd4d84.pdf
dx.doi.org/10.21608/ejgg.2014.5336
Comparison of tools for nutritional assessment in elderly patients: A pilot study
Nesma
Ahmed
Assistant Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
Menna
Shawkat
Assistant Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
Marian
Mansour
Assistant Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
Hazem
Hussien
Assistant Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
Doha
Rasheedy
Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt.
author
text
article
2014
eng
Background: Malnutrition is a major health related concern associated with higher morbidity and mortality in the elderly compared to their younger counterparts. Malnutrition is not an inevitable side effect of ageing, but many changes related to ageing can cause malnutrition. The early recognition of patients at high risk of malnutrition is needed to timely manage the condition and avoid its adverse outcomes. Several types of nutrition screening tools have been developed for evaluating the nutritional status of elders; however, the Mini-Nutritional Assessment-Short Form (MNA-SF) is the most widely used tool. Aim: The aim of this study is to identify the most appropriate nutritional screening tool for use in hospitalized elderly population. Method: Mini-Nutritional Assessment-Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), The Nutritional risk screening (NRS), Patient-Generated Subjective Global Assessment (PG-SGA) and Geriatric nutritional risk index (GNRI) were administered to 20 patients. All patients were 60 years and over. Results: Using the MNA-SF 12 (60%) of the studied sample were malnourished and 8 (40%) had normal nutritional status. Tools performance in predicting malnutrition was calculated. The sensitivity was 91%, 83%, 83% and 66% and specificity was 50%, 62%, 12% and 75% with the NRS, MUST, PG-SGA and GNRI, respectively. Combining different pairs of tools MUST and NRS together had better sensitivity 92.8% and specificity 66.6% then 2nd better two tools together is NRS and GNRI with sensitivity 91.6% and specificity 50% with accuracy 75% other tools showed high sensitivity but low specificity as PGSGA with NRS and PGSGA and GNRI. Conclusion: NRS had the highest sensitivity while GNRI had the highest specificity among different studied assessment tools. MUST and NRS together had better sensitivity but lower specificity than either tool alone. Combining the NRS and GNRI had better sensitivity than GNRI alone and better specificity than NRS alone. We recommend using NRS alone as the optimal screening tool.
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
53
59
https://ejgg.journals.ekb.eg/article_5337_6b49b87482388dd726944ae2cae32652.pdf
dx.doi.org/10.21608/ejgg.2014.5337
Development and Validation of a Nutritional Health Education Program for Health Care Providers in Geriatric Homes
Dina.
Abdel Raouf
Community, Environmental and Occupational Medicine department
author
Tomader
Abdel Rahman
Geriatrics and Gerontolongy department, Faculty of medicine, Ain-Shams University, Egypt.
author
Ghada
Amin
Community, Environmental and Occupational Medicine department,
author
Maha
El Gaafary
Community, Environmental and Occupational Medicine department,
author
Diaa
Abdel Hamid
Community, Environmental and Occupational Medicine department
author
Mohamed
El Awady
Community, Environmental and Occupational Medicine department
author
text
article
2014
eng
Objectives: To develop and implement a health education program for health care providers (HCPs) in geriatric homes about nutrition in Elderly and to evaluate the program in terms of: HCP‘s knowledge before and after the program, and to assess nutritional status of elderly served by HCP before and after the program and also to measure the frequency of different malnutrition risk factors in elderly at geriatric homes. Subjects and methods: Randomized Clustered Controlled Clinical Trial was conducted on 240 elderly residing in 6 geriatric homes randomly selected. Three homes were assigned randomly to study group and three for control group. Elderly residing in the assessd geriatric homes aged between 60-75 years were included in the study. Health care providers (HCP) recruited was subdivided into 2 groups; study group and control group. HCP in the study group were subjected to a nutrition education program that was not administered to the control group. Results: There was improvement in knowledge of HCPs after the intervention health education program regarding elderly nutrition compared to the baseline knowledge and also to control group (p<0.005). There was a statistical significant difference in the rate of weight loss which was declined over a period of 4 months from the beginning of the study on June 2012 till October 2012 in both groups (p <0.001), but the rate of weight loss had declined after the intervention at the end of the study in the study group compared to the control group. Most of the elderly were overweight BMI >30 (67.1%). Nearly half of the elderly (52.9%) were at risk of malnutrition with the MNA (Mini Nutritional Assessment) score (17.1-23.5). The majority of the elderly 98.8 % were at risk of significant weight loss of at least 5% within 6 months by using the Appetite Assessment tool score with sum of score <=14. The majority of the elderly (98.3%) had a dental problem as(loss of teeth, eating difficulty, dry mouth or lesions) that may affect health and nutritional well-being with a score of >=2 by using Dental screening tool. There was improvement in physical aspect of quality of life in terms of activities and instrumental activities of daily living after implementation of the nutrition health education program in the study group compared to control group (p<0.001) Conclusion: Geriatric homes need continuous monitoring and reinforcement of health education of the health care providers and this will be reflected on the nutritional status and well being of the elderly residing in these Geriatric homes. Raising the awareness of the elderly is needed to improve not only the nutritional state but also the physical and psychological aspects of quality of life to have better health outcomes and good healthy elders.
The Egyptian Journal of Geriatrics and Gerontology
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
2356-8712
1
v.
1
no.
2014
60
67
https://ejgg.journals.ekb.eg/article_5338_62181d04784a7a58f656ee5204dd743e.pdf
dx.doi.org/10.21608/ejgg.2014.5338