Yaşlı Erişkinlerde Kırılganlık ve Anemi Arasındaki İlişki

Amaç: Anemi yaşlı erişkinlerde morbidite ve mortalitenin yaygınbir nedenidir. Anemi ile düşük fiziksel performans arasında güçlüilişki vardır. Ancak aneminin kırılganlık sendromu üzerindekietkisi net olarak bilinmemektedir. Bu çalışma, anemi vekırılganlık arasındaki ilişkiye odaklanmaktadır.Gereç ve Yöntemler: Geriatri Kliniğinde takipli 383 hastaçalışmaya alınarak, hastalara ayrıntılı geriatrik değerlendirmeuygulandı. Tüm hastalar komorbidite açısından sorgulandı. Anemitanısı kadınlarda hemoglobin seviyesinin 12,2 g/dL ve erkeklerde13,2 g/dL’nin altında olması olarak kabul edildi.Bulgular: Hastaların 103’ünde (%26,9) anemi saptandı.Hastaların yaş ortalaması anemisi olan grupta anlamlı olarak dahayüksekti (p=0,01). Anemisi olan gruptaki bireylerin ilaç kullanımsayısının daha fazla olduğu, diabetes mellitus ve depresyonundaha yüksek olduğu saptandı. Fried kırılganlık ölçeğine göreanemik bireylerde kırılganlık skoru anlamlı olarak daha yüksekti(p&lt;0,01). Ayrıntılı Geriatrik Değerlendirmede kullanılan POMA(Performans Doğrultusunda Mobilite-Denge DeğerlendirmeTesti), Temel ve Enstrumental Günlük Yaşam Aktiviteleri, Kalkve Yürü Testi, Mini Nutrisyon Değerlendirme-Kısa Formutestlerinden alınan kötü sonuçların anemi grubunda daha fazlaolduğu saptandı (p&lt;0,01). Katılımcıların verilerinde yaş, cinsiyet,eğitim süresine göre düzeltme yapıldığında anemi ile kırılganlık(Odds Oranı 1,82 %95 Güven Aralığı 1,03-3,20 P=0,03) sıklığıarasında anlamlı ilişki olduğu görüldü.Sonuç: Anemi, kolaylıkla taranabilen bir laboratuvar bulgusudur,ancak yaşlılarda kırılganlıkla ve kötü sağlık sonuçlarıyla ilişkiliolabilir. Bu nedenle, anemisi olan yaşlı bireylerin tanı ve tedaviiçin çok yönlü değerlendirilmesi önerilir.&nbsp;Aim: Anemia is a common cause of morbidity and mortality inolder adults. There is a strong association between anemia andpoor physical performance. However, the effect of anemia onfrailty is not known clearly. This study focuses on the relationshipbetween anemia and frailty.Material and Methods: Comprehensive geriatric assessment wasperformed on 383 patients who were followed up in the GeriatricsClinic. All patients were questioned in terms of comorbidity. Thediagnosis of anemia was accepted as a hemoglobin level below12.2 g/dL in women and 13.2 g/dL in men.Results: Anemia was detected in 103 (26.9%) patients. The meanage of the patients was significantly higher in the anemia group(p=0.01). It was determined that the individuals in the anemiagroup had a higher number of drug use, diabetes mellitus, anddepression. According to the Fried frailty scale, the frailty scorewas significantly higher in anemic individuals (p&lt;0.01). Poorresults obtained from POMA (Mobility-Balance Evaluation Testin the Direction of Performance), Basic and InstrumentalActivities of Daily Living, Up and Go Test, Mini NutritionAssessment-Short Form tests used in Comprehensive geriatricassessment were found in the anemia group (p&lt;0.01). When theparticipants' data were adjusted for age, gender, and duration ofeducation, a significant correlation was found between thefrequency of anemia and frailty (Odds Ratio 1.82 95% ConfidenceInterval 1.03-3.20 P=0.03).Conclusion: Anemia is an easily screenable laboratory findingbut may be associated with frailty and poor health outcomes in theelderly. Therefore, it is recommended that older individuals withanemia be evaluated comprehensively for diagnosis and treatment.</p

E-mail-based health care in patients with dementia during the pandemic

Introduction/aimFrail and cognitively impaired older patients are particularly vulnerable groups during the pandemic. Lockdowns, social isolation, and physical inactivity considerably affect physical and mental wellbeing. During the pandemic process, routine medical checks and acute medical care services may be disrupted. The study aimed to demonstrate the feasibility and effectiveness of telemedicine in the delivery of healthcare services to elderly patients during the pandemic. Materials and methodsE-mails sent to the e-mail address of the department of geriatrics, which has been actively used for 4 years, between April 2020 and June 2021, were retrospectively evaluated. The time and reason for each application, referral to the patients, demographic data of the patients, and chronic diseases were recorded. E-mail frequencies were considered monthly time series, and time series charts for e-mail frequencies from patients were produced. ResultsA total of 374 e-mails that 213 patients sent were assessed. A vast majority, 97.6% of the e-mails, were sent by proxies. The mean age of patients was 78.7 +/- 8.1 years, and 59.2% were women. Hypertension and dementia were the most common comorbidities. The applications mostly occurred in April-May and October-November 2020. The most common complaint in dementia was behavioral disturbances (13.6%). Geriatric outpatient appointments were arranged for 29.9% of the applicants, 14.2% were referred to the emergency department, and 23.0% were offered medical treatment. Outpatient examination and treatment were completed in 15% of the patients and 10.4% of them were hospitalized. The time series charts showed that e-mails were sent more frequently by patients with dementia than the others (p = 0.03). ConclusionsTelemedicine, which enables many problems of patients to be solved in geriatric practice without face-to-face appointments, can also prevent infections and unnecessary hospitalizations, especially during these unusual pandemic days