Mobility impairment in the elderly

2018 ◽  
Vol 11 (1) ◽  
pp. 14-19
Author(s):  
Rabia Mahmood Khan
Keyword(s):  
Primary Care ◽  
Older People ◽  
Functional Ability ◽  
Clinical Relevance ◽  
The Elderly ◽  
Clinical Disease ◽  
Screening Tools ◽  
Early Interventions ◽  
Mobility Impairment ◽  
Mobility Impairments

Decline in functional ability among the elderly is of clinical relevance as a marker of potentially treatable clinical disease. It is possible to screen older people for mobility issues and apply early interventions to prevent mobility problems and rehabilitate existing mobility impairments. This article discusses the predictors of mobility decline, available screening tools and the prevention and management of mobility impairment in primary care.

scholarly journals Characteristics of patients receiving health assessments, care plans or case conferences by general practitioners, as part of the Enhanced Primary Care program between November 1999 and October 2001

2002 ◽  
Vol 25 (6) ◽  
pp. 120
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Indigenous People ◽  
Care Program ◽  
The Elderly ◽  
Care Plans ◽  
Department Of Health ◽  
Health Assessments ◽  
Case Conferences ◽  
Gender Patterns

We aimed to describe the characteristics of patients receiving health assessments (HA), care plans (CP) or case conferences (CC) through the Enhanced Primary Care (EPC) program between November 1999 and October 2001. The Commonwealth Department of Health and Ageing provided data. In all, 43%of non-Indigenous people who had a HA were aged 75-79 years and 32%were aged 80-84 years. Those having a HA at home were older (30.3% aged 85 years and above) than those having a HA in GP's rooms (20.2%85 years and above). For Indigenous people, between 12 and 17%of all HAs were done among each five-year age group between 55 and 84 years. As a group, CPs were mostly done among older people, with a higher proportion done among older women (74.2%among those 55 years and above) than older men (66.4%). Most CCs were also done among older people (60.4%55 years and above). Of the 286,250 people that had at least one EPC service, most (219,210; 76.6%)had only one. Of these, 153,624 (70.1%)had a HA. Of those having at least one EPC service, 95.7%had two services (most often a HA plus a CP). To date EPC activity has been concentrated among the elderly, gender patterns are similar, and few patients have received more than a single EPC service, which is usually a HA.

scholarly journals Engaging older people in an internet platform for cardiovascular risk self-management: a qualitative study among Dutch HATICE participants

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019683 ◽  
Author(s):  
Tessa van Middelaar ◽  
Cathrien R L Beishuizen ◽  
Juliette Guillemont ◽  
Mariagnese Barbera ◽  
Edo Richard ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Computer Literacy ◽  
The Elderly ◽  
Self Management ◽  
Daily Routine ◽  
Semistructured Interview ◽  
User Friendliness ◽  
Increased Risk ◽  
Internet Platform

ObjectivesTo study older peoples’ experiences with an interactive internet platform for cardiovascular self-management, to assess which factors influence initial and sustained engagement. To assess their views on future use within primary care.DesignQualitative semistructured interview study, with thematic analysis.SettingPrimary care in the Netherlands.ParticipantsPeople ≥65 years with an increased risk of cardiovascular disease who used the ‘Healthy Ageing Through Internet Counselling in the Elderly’ internet platform with remote support of a coach. Participants were selected using a purposive sampling method based on gender, age, level of education, cardiovascular history, diabetes, duration of participation and login frequency.ResultsWe performed 17 interviews with 20 participants, including three couples. In the initial phase, platform engagement was influenced by perceived computer literacy of the participants, user-friendliness, acceptability and appropriateness of the intervention and the initial interaction with the coach. Sustained platform use was mainly facilitated by a relationship of trust with the coach. Other facilitating factors were regular automatic and personal reminders, clear expectations of the platform, incorporation into daily routine, social support and a loyal and persistent attitude. Perceived lack of change in content of the platform could work both stimulating and discouraging. Participants supported the idea of embedding the platform into the primary care setting.ConclusionsHuman support is crucial to initial and sustained engagement of older people in using an interactive internet platform for cardiovascular self-management. Regular reminders further facilitate sustained use, and increased tailoring to personal preference is recommended. Embedding the platform in primary healthcare may enhance future adoption.Trial registration numberISRCTN48151589; Pre-results.

Frailty syndrome: an old new friend

2014 ◽  
Vol 155 (49) ◽  
pp. 1935-1951
Author(s):  
Sára Kálmán ◽  
Magdolna Pákáski ◽  
János Kálmán
Keyword(s):  
Primary Care ◽  
Chronically Ill ◽  
Risk Groups ◽  
The Elderly ◽  
Screening Tools ◽  
Pathophysiological Mechanism ◽  
Frailty Syndrome ◽  
Extreme Stress ◽  
Adverse Health Outcomes ◽  
Phenotype Model

Frailty syndrome is defined as extreme stress vulnerability and decreased potential to adapt. The elderly and chronically ill patients are affected mostly. This condition increases the risk of adverse health outcomes as infections, falls, delirium, institutionalization, progression of comorbidities and mortality. The pathophysiological mechanism is a complex immune and neuroendocrine dysregulation. According to the phenotype model, frailty presents when three of the followings occur: weakness, exhaustion, slowness, weight loss and decreased activity, while cumulative model counts the number of health deficits. Aging, frailty, dementia and depression are independent clinical entities; they may present separately but may also potentiate each other. Hence most of the frailty scales assess the physical, mental and social dimensions as well. Mild or moderate frailty is potentially reversible with an individualised caring plan. Given short, easy-to-use screening tools, risk groups can be identified in the primary care and referred to a specialised team for further treatment. Here the authors summarise the literature of a re-discovered, current clinical phenomena, frailty syndrome, focusing on the practical issues in primary care. Orv. Hetil., 2014, 155(49), 1935–1951.

scholarly journals Falls Among the Elderly and Vision: A Narrative Review

2014 ◽  
Vol 1 (1) ◽  
pp. 54-65 ◽  
Author(s):  
Ray Marks
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Functional Ability ◽  
The Elderly ◽  
Research Literature ◽  
Societal Costs ◽  
Factors Influencing ◽  
Life Impact ◽  
Insight Into

Falls among older people are widespread, and can be catastrophic in terms of injury magnitude, quality of life impact, and increased mortality risk. Among a multitude of factors influencing falls risk rates among older people are deficits in vision, and/or their effects on locomotion, balance, and functional ability. This review discusses the above topic, offers insight into what can be done in this realm based on the current body of literature. Sources drawn from leading peer review articles published over the last 30 years using key words: falls, vision, injury, fracture were retrieved and are analyzed and discussed. On this basis, the importance of falls and their prevention, and future clinical and research directives are highlighted. Expected to increase in prevalence falls cause much undue distress and high personal, as well as societal costs. The research literature on vision and falls, despite having major implications, remains limited at best, at present.

scholarly journals A brief assessment unravels unmet needs of older people in primary care: a mixed-methods evaluation of the SPICE tool in Portugal

2018 ◽  
Vol 19 (6) ◽  
pp. 637-643 ◽  
Author(s):  
Conceição Balsinha ◽  
Maria J. Marques ◽  
Manuel Gonçalves-Pereira
Keyword(s):  
Primary Care ◽  
Older People ◽  
Emotional Distress ◽  
Unmet Needs ◽  
Unmet Need ◽  
The Elderly ◽  
Community Dwelling ◽  
Brief Assessment ◽  
Mixed Methods Evaluation ◽  
Camberwell Assessment Of Need

Assessments of need may contribute to identifying health problems associated with functional deterioration in older people. A shorter version of the Camberwell Assessment of Need for the Elderly was developed for routine use in primary care, focusing on five domains: Senses, Physical ability, Incontinence, Cognition, and Emotional distress (SPICE). We aimed to explore its usefulness and feasibility in primary care.We selected a consecutive sample of 51 community-dwelling older adults. The SPICE interview was completed by GPs and patients, with perceptions about its use in primary care being explored.Needs were identified in 38 patients. Unmet needs corresponded to 7% of needs overall. ‘Emotional distress’ was the most frequent unmet need. SPICE helped to identify undisclosed needs, was well accepted and its importance in clinical evaluation recognised by GPs and patients, despite concerns about time constraints. Facilitating strategies are needed to improve the feasibility of these assessments in primary care.

scholarly journals Health literacy of older people in primary care

2012 ◽  
Vol 25 (spe1) ◽  
pp. 129-135 ◽  
Author(s):  
Lisiane Manganelli Girardi Paskulin ◽  
Carla Cristiane Becker Kottwitz Bierhals ◽  
Daiany Borghetti Valer ◽  
Marinês Aires ◽  
Nara Veras Guimarães ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Literacy ◽  
Health Education ◽  
Older People ◽  
The Elderly ◽  
Descriptive Study ◽  
Primary Care Unit ◽  
Qualitative Descriptive ◽  
Education Groups ◽  
Share Information

OBJECTIVE: To analyze how elderly people linked to health education groups of a primary care unit seek, understand and share information, aiming to maintain and promote health throughout life. METHODS: Qualitative descriptive study, conducted with 30 elderlies linked to three groups of health education during the second semester of 2009. The data collection was performed through interviews and thematic analysis with the assistance of the NVivo software. RESULTS: Five categories of analysis were elaborated - Interest/concern in health, search, understanding, sharing and impact of information on the elderly. CONCLUSIONS: The health literacy in the groups developed in an individual perspective, focused on the prevention and treatment of injuries, respecting the history and knowledge of the subjects and appreciating the possibilities of exchange among them. The results support the planning, implementation and improvement of actions in health education with older people in primary care.

scholarly journals Primary Care Variation in Rates of Unplanned Hospitalizations, Functional Ability, and Quality of Life of Older People

2021 ◽  
Vol 19 (4) ◽  
pp. 318-331
Author(s):  
Leah Palapar ◽  
Ngaire Kerse ◽  
Laura Wilkinson-Meyers ◽  
Thomas Lumley ◽  
Jeanet W. Blom
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Older People ◽  
Functional Ability ◽  
Unplanned Hospitalizations

scholarly journals The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

2021 ◽  
Vol 9 (A) ◽  
pp. 572-578
Author(s):  
Ainash Ibysheva ◽  
Gulmira Muldaeva ◽  
Leila I. Arystan ◽  
Almagul B. Kuzgibekova ◽  
Bibigul A. Abeuova ◽  
...  
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Screening Tools ◽  
Potentially Inappropriate Prescribing ◽  
Care Level ◽  
Primary Care Level ◽  
Start Criteria ◽  
Prescribing Omissions

BACKGROUND: These potentially inappropriate prescribing is associated with the development of undesired medical reactions in elderly patients, and increase the frequency of hospitalizations, the number of aggravations and the cost of treatment. All of these adverse events are preventable. For detection of PIP and to prevent the adverse drug reactions (ADRs) in elderly patients, it is necessary to screen for potentially inappropriate prescribing. AIM: The aim of the study is to study the prevalence of PIP and the factors associated with these prescriptions at the level primary link in Kazakhstan. METHODS: A prospective descriptive study was carried out at the primary care level, in five clinics in Kazakhstan. The study involved 205 patients over 65 years old who received regular outpatient treatment for chronic diseases. Patients’ current diagnoses and prescription medicines were reviewed and the STOPP and START tools applied. RESULT: The prevalence of PIP in terms of STOPP criteria was 54% (114 patients). In general, we have identified 181 cases of PIP. The most commonly prescribed PIP were moxonidine (20%), glimeperide (16.5%), and PPI (20%). The prevalence of prescribing omissions in terms of START criteria was 22% (48 patients). Overall 66 cases of prescribing omissions were identified. The most commonly prescribed omissions were statins (6%) and ACE inhibitors (4%). Comparative analysis revealed a statistically significant effect of polymorbidity on the prevalence of PIP (p < 0.001) and number of prescribed medicines on the prevalence of PIP (p < 0.05). We have found a statistically significant effect of age on the presence of prescribing omissions of patients. (p < 0.001) CONCLUSION: Our results showed a high prevalence of potentially inappropriate prescribing at the primary care level in Kazakhstan. Screening tools should be incorporated into the everyday practice of primary care doctors.

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