Impact of Comorbidities and Prospective Functional Geriatric Assessment Tools (CF-GA) As an Aide to Understand Outcome, Therapy Tolerance, Side Effects and Clinical Trial Eligibility in Multiple Myeloma (MM) Patients (pts)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5616-5616
Author(s):  
Alexander Zober ◽  
Mandy Möller ◽  
Sandra-Maria Dold ◽  
Gabriele Ihorst ◽  
Stefanie Hieke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Research Funding ◽  
Performance Status ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Timed Up And Go ◽  
Comorbidity Index

Abstract Introduction: Cancer pts present with a highly heterogeneous health status and treatment choices are often numerous. Therefore, careful assessment of individuals' condition is highly relevant. In order to define best possible and tolerable treatment options, novel parameters and metrics for non-disease variables are needed. Albeit impairment in the Karnofsky Performance Status (KPS), Activities of Daily Living (IADL or ADL) and quality of life (QoL) are predictive for outcome in cancer and MM pts, the prognostic variables within a defined and prospectively assessed battery of established functional tests have rarely been delineated nor have their combination with disease-related risk factors or molecular markers been meticulously assessed. Their prognostic value for functional decline and overall survival (OS) has also not been tested and validated prospectively. Methods: We performed this comorbidity and functional geriatric assessment (CF-GA) in consecutive MM pts treated at our center according to our institutional Comprehensive Cancer Center pathway. The GA was prospectively obtained prior to initiation of anti-myeloma treatment and reflected pts' baseline health status rather than being confounded by toxicities induced by therapy. This CF-GA included the IADL, ADL, Timed Up and Go-Test, malnutrition, pain, rating of fitness, SF12-QoL and geriatric depression scale. Moreover, established comorbidity (CM) scores: ß2MG/eGFR (Eur J Haematol. 2009;83:519-27), Kaplan Feinstein (KF), Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI), Charlson Comorbidity Index (CCI) and initial Freiburg Comorbidity Index (iFCI) vs. revised FCI (rFCI) were assessed. This CF-GA was performed as one screening tool to assess pt fitness as well as to predict survival and toxicities in elderly myeloma pts. Results: Characteristics of 131 pts, currently included in this CF-GA, were typical for tertiary centers with a median age of 63 years (40-83), all with symptomatic disease. Their median hemoglobin was 10.8g/dl (7.6-14.7), the eGFR 68ml/min/1.73qm (7-136), the ß2-MG 4.4mg/l (0.8-38.4) and BM infiltration 40% (3-90). The baseline frailty assessment revealed a median KPS of 80% (40-100). The fitness score scaled both by physicians and patients was 4 vs. 3 (1-6), demonstrating that physicians overestimate pts' performance status and objective tests to verify this are essential. Median functional results for the IADL were 5 (1-8), for the ADL 4 (2-6), for pain 2 (0-10), for malnutrition 4 (0-14) and for cognitive deficiency via Mini Mental State Examination 28 (16-30). The median geriatric depression scale was 3 (0-13) and Timed Up and Go-Test 10 (4-30). Median CM scores were substantially different with an iFCI of 0 (0-3), ß2MG/eGFR of 1 (0-2), KF of 1 (0-3), HCT-CI of 2 (0-8), rFCI of 4 (0-9) and CCI of 7 (0-12). Highly valuable CF-GA-tools seem currently the IADL, Timed Up and Go-Test and rFCI. Since CF-GA is a time and man-power consuming procedure, we have presently completed a web account that allows the straightforward assessment of the rFCI for MM pts (https://rfci-score.org). This permits to perform this score in only 1-2 minutes. Moreover, we continue to perform this prospective assessment in more MM pts at our center and within a multicentre approach within the German Study Group Multiple Myeloma(DSMM) and will thereby also assess whether these function deficits and tests change over time. Prior scores to define fit, intermediate and frail pts (Blood. 2015;125:2068-74) will be compared with our risk group definitions and their predictive power for progression free survival, overall survival, side effects, therapy termination/discontinuation and early mortality will be evaluated. Adverse risk groups will allow to test and validate the most significant predictors of survival outcomes. Conclusions: Our CF-GA and rFCI contain easily assessable and reliable tests, which are of value to further test for their discriminative character in MM pts. Moreover, most predictive CF-CA tools need to be determined in prospective multicentre cohorts and need to be included in future clinical trials. We advocate our CF-GA and rFCI to foresee treatment toxicity, facilitate treatment decisions and guide personalized therapies. Timely identification and management of risk factors in MM pts are important considerations in the daily care of older and frail cancer pts, specifically those with MM. Disclosures Zober: Deutsche Krebshilfe: Other: grant. Knop:Celgene Corporation: Consultancy. Einsele:Amgen/Onyx: Consultancy, Honoraria, Speakers Bureau; Novartis: Consultancy, Honoraria, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Celgene: Consultancy, Honoraria, Research Funding, Speakers Bureau. Engelhardt:Deutsch Krebshilfe: Other: grant.

scholarly journals Comparison of the Freiburg and Charlson Comorbidity Indices in Predicting Overall Survival in Elderly Patients with Newly Diagnosed Multiple Myeloma

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Sung Min Kim ◽  
Moon Jin Kim ◽  
Hyun Ae Jung ◽  
Kihyun Kim ◽  
Seok Jin Kim ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Elderly Patients ◽  
Performance Status ◽  
Solid Cancer ◽  
Newly Diagnosed ◽  
History Of ◽  
Comorbidity Index ◽  
And Performance ◽  
The Impact

Multiple myeloma occurs primarily in elderly patients. Considering the high prevalence of comorbidities, comorbidity is an important issue for the management of myeloma. However, the impact of comorbidity on clinical outcomes has not been fully investigated. We retrospectively analyzed patients with newly diagnosed myeloma. Comorbidities were assessed based on the Charlson comorbidity index (CCI) and the Freiburg comorbidity index (FCI). The CCI is a summary measure of 19 comorbid conditions. FCI is determined by performance status, renal impairment, and lung disease. This study included 127 patients with a median age of 71 years. Approximately half of the patients had additional disorders at the time of diagnosis, and diabetes mellitus was the most frequent diagnosis (18.9%). The most significant factors for prognosis among patient-related conditions were a history of solid cancer and performance status (ECOG ≥ 2). The FCI score was divided into 3 groups (0, 1, and 2-3), and the CCI score was divided into 2 groups (2-3 and ≥4). FCI was a strong prognostic tool for OS (P>0.001) and predicted clinical outcome better than CCI (P=0.059). In conclusion, FCI was more useful than CCI in predicting overall survival in elderly patients with myeloma.

scholarly journals Treatment Outcomes of Real Life Elderly Multiple Myeloma Patients:Â Analysis from Registry of Monoclonal Gammopathies (RMG)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2019-2019
Author(s):  
Jakub Radocha ◽  
Roman Hajek ◽  
Lucie Brozova ◽  
Ludek Pour ◽  
Ivan Spicka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Treatment Outcomes ◽  
Board Of Directors ◽  
Research Funding ◽  
Statistical Significance ◽  
Real Life ◽  
Advisory Committees ◽  
Monoclonal Gammopathies

Abstract Introduction: Multiple myeloma patients over the age of 65 represent the majority of myeloma population. The main goal was to evaluate treatment outcomes in terms of overall survival for elderly patients based on initial choice of anti-myeloma drugs, and to find potential factors affecting survival. Patients and Methods: This is a retrospective registry based analysis from the Registry of monoclonal gammopathies of the Czech Myeloma Group. Patients with multiple myeloma diagnosed between 2007-2016 over the age of 65 with symptomatic myeloma were included in the analysis. Basic demographic data and disease characteristics were obtained. The Kaplan-Meier estimates were completed by the Greenwood confidence interval. The log-rank test was used to estimate the statistical significance of the difference between the curves. The Cox proportional hazards model was performed to explore the univariate significance of risk factors. Results: Data from 1410 MM patients were obtained. Gender [HR 1.316 (1.124-1.541), p=0.001], age [above 75 vs. 66-75, HR 1.437 (1.221-1.692), p< 0.001], creatinine levels [at cutoff 152 µmol/L, HR 1.613 (1.365-1.905), p< 0.001] and ECOG performance status [0-1 vs. 2-4, 1.869 (1.594-2.191), p< 0.001] were found to significantly affect overall survival. Moreover these risk factors have cumulative effect on overall survival of the patients. Overall survival of patients regardless to above mentioned risk factors treated with upfront bortezomib (N = 880) was median OS 40.4 months (CI: 36.1-44.7), patients treated with upfront thalidomide (N = 370) had median OS 48.1 months (CI: 41.0-55.2), for lenalidomide (N = 64) median overall survival was 53.2 months (CI: 44.6-61.8) and for combination of bortezomib and thalidomide (N = 46) 32.2 months (CI: 26.6-37.8). When any of these risk factors was present the OS in each group shortened. In the group of patients with no risk factors (N = 255) the median OS for bortezomib (N = 126) was not reached, for thalidomide (N = 96) the median OS was 66.3 months (CI: 43.1-89.6), for lenalidomide (N = 17) 71.1 months (CI: 44.8-97.4) and for combination of bortezomib and thalidomide (N=8) was not reached. In the group of patients with 1 risk factor (N = 514) the median OS for bortezomib (N = 303) was 46.1 months (CI: 36.2-56.1), for thalidomide (N = 141) 56.2 months (CI: 47.5-64.9), for lenalidomide (N = 29) 49.0 months (CI: 9.7-88.2) and for combination of bortezomib and thalidomide (N=20) was not reached. In the group of patients with 2 risk factors (N = 420) the median OS for bortezomib (N = 288) was 34.0 months (CI: 24.7-43.4), for thalidomide (N = 87) 31.9 months (CI: 22.8-40.9), for lenalidomide (N = 14) 33.2 months (CI: 0.0-67.6) and for combination of bortezomib and thalidomide (N=20) 29.4 months (CI: 7.6-51.1). In the group of patients with 3-4 risk factors (N = 221) the median OS for bortezomib (N = 163) was 19.2 months (CI: 14.9-23.5), for thalidomide (N = 46) 18.9 months (CI: 13.0-24.7), for lenalidomide (N = 4) 6.1 months (CI: 0.0-63.0) and for combination of bortezomib and thalidomide (N=3) 14.3 months (CI:-). Conclusion: The overall survival of patients above the age of 65 shows promising results with the use of novel agents. The treatment outcomes seem to be generally affected by overall condition, age and gender of the patient rather than treatment modality used upfront. Figure. Figure. Disclosures Hajek: Amgen: Consultancy, Honoraria, Research Funding; Bristol Myers Squibb: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria, Research Funding; Novartis: Research Funding. Maisnar:Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees.

scholarly journals Multiple Myeloma Patients with Lenalidomide-Associated Skin Rash Have a Favorable Prognosis

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4532-4532 ◽  
Author(s):  
Ayumi Kojima ◽  
Yuka Tanaka ◽  
Yuta Kimura ◽  
Daisuke Tsuchimoto ◽  
Rina Etani ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Skin Rash ◽  
Research Funding ◽  
Kinase Inhibitors ◽  
Performance Status ◽  
Progression Free Survival ◽  
Rank Test ◽  
Free Survival ◽  
The Relationship

Abstract Background: Lenalidomide, one of the immunomodulatory drugs, is an important component of treatment for multiple myeloma. Lenalidomide inhibits the proliferation of tumor cells via antiangiogenesis, induces apoptosis and acts directly on the immune system and tumor microenvironment. Immunomodulatory effects of lenalidomide notably stimulate the production of cytokines and activation of T-cells and natural killer cells. Skin rash is a frequent adverse event of lenalidomide. Some studies have shown a correlation between the efficacy of anti-cancer agents such as tyrosine kinase inhibitors and the development of skin rash. However, the relationship between the development of lenalidomide-associated skin rash and its efficacy is unclear. We conducted a retrospective survey to clarify whether development of skin rash correlates with the efficacy of lenalidomide. Materials and Methods: All patients with multiple myeloma who received lenalidomide at 9 hospitals in Japan from July 2009 to December 2015 were serially registered. The chart review was performed for all identified patients to obtain the following information; age, sex, performance status at the initiation of lenalidomide, International Staging System (ISS) classification, prior chemotherapy regimen, tumor response, development of skin rash and clinical outcomes. A log-rank test was used to assess the relationship between the presence of skin rash and survival. A two-sided p < 0.05 was considered statistically significant. This study received approval from the appropriate ethics committees. Results: We identified 215 patients (92 women and 123 men), with a median age was 69 years (range, 39-86 years). Types of myeloma were as follows: 139 patients of IgG, 43 of IgA, and 29 of Bence-Jones protein. ISS was available for 204 patients, and of these, 63, 73, and 68 patients were classified as ISS stage I, II, and III, respectively. The median number of prior therapies was 2 (range, 0-6); 161 (74.9%) and 46 patients (21.4%) had previously received bortezomib and thalidomide, respectively. Fifty patients (23.3%) had undergone previous autologous stem cell transplantation. Sixty-five patients (30.2%) developed a skin rash after lenalidomide initiation, and the median time to onset of skin rash was 12 days. The patients with and without skin rash were similar with respect to age, type of myeloma, and ISS. The median follow-up of survivors was 28.9 months (range, 1.7-80.3 months). The progression-free survival and overall survival were better in patients who had skin rash than in those who did not (p = 0.009 and p = 0.033, respectively) (Figures A and B). Conclusions: In this study, the progression-free survival and overall survival among patients with skin rash during lenalidomide therapy was significantly superior to the patients without skin rash. Lenalidomide-associeated skin rash in patients with multiple myeloma may be a predictive factor of their clinical outcome. Figure Figure. Disclosures Nagai: Takeda: Honoraria, Research Funding; Janssen: Research Funding; Mundipharma KK: Research Funding.

Risk Factors For The Development Of Severe Bacterial Infection In Patients With Multiple Myeloma During Chemotherapy With Bortezomib Containing Regimens

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5370-5370 ◽  
Author(s):  
Shin Young Hyun ◽  
Ji Eun Jang ◽  
Yundeok Kim ◽  
Doh Yu Hwang ◽  
Soo Jeong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Risk Factor ◽  
Bacterial Infection ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Severe Bacterial Infection ◽  
Early Course

Abstract Background The aim of this study is to identify risk factors associated with the development of severe bacterial infection (SBI) in patient with multiple myeloma (MM) during treatment with bortezomib-containing regimens. Methods A total of 98 patients with MM who were treated with bortezomib-based treatment between 2006 and 2012 were analyzed. Fifty three patients received bortezomib-dexamethasone, 25 patients received bortezomib-melphalan-prednisolone, 15 patients received bortezomib-doxorubicin-dexamethasone and 5 patients received other regimens. They received a total of 427 courses of treatment. The SBI was defined as at least grade 3 neutropenic/non-neutropenic infection by NCI Common Terminology Criteria for Adverse Events version 4.0. Using the logistic regression method, we analyzed risk factors for the development of SBI during each course of treatment. Results Median age of the patients was 62 years and 40.6% (30/98) of patients treated with bortezomib-containing regimens as first-line therapy. The SBI was developed in 57% (56/98) of patients and 19% (81/427) of bortezomib courses. Among 81 episodes of SBI, 42 (53%) episodes were clinically documented infection, 30 (37%) were microbiologically documented infections, and 9 (11%) were fever of unknown origin. The most common type of infection was pneumonia (60%). Poor performance status (ECOG ≥2) (Hazard Ratio [HR] 5.365, 95% Confidence Interval [CI] 2.004-14.364, P =.001) was the only risk factor for the development of SBI in 98 patients. When we analyzed the risk factors for the development of SBI which occurred during each treatment course, poor performance status (ECOG ≥2) (P <.001), early course of treatment (≤2 courses) (P <.001) and pretreatment lymphopenia (absolute lymphocyte count <1.0 x 109/L) (P = .043) were associated with increased risk for developing SBI in each course. These 3 risk factors remained independently significant in multivariate analysis: poor performance status (ECOG ≥2) (HR 3.920, 95% CI 2.305-6.666, P <.001), early course of treatment (≤2 courses) (HR 2.782, 95% CI 1.633-4.740, P <.001) and pretreatment lymphopenia (HR 1.728, 95% CI 1.016-2.937, P = .043). The probability of developing SBI in each treatment course was 5.1% in courses with no risk factor, 14.9% in 1 risk factor, 23.9% in 2 risk factors and 59.5% in 3 risk factors (P <.001, Figure 1). After treatment with bortezomib-containing regimens, patients who experienced SBI showed a significantly shorter overall survival than patients who didn't experienced SBI (median 6.1 month vs. 30.1 months, P = .004) although progression free survival was not different (median 18.1 months vs. 21.9 months, P = .418). The multivariate cox analysis demonstrated that the development of SBI was associated with inferior overall survival (HR 2.440, 95% CI 1.305-4.561, P = .005) as well as male sex (HR 2.323, 95% CI 1.236-4.367, P = .009). Conclusions In conclusion, we identified that poor performance status, early courses of treatment, and lymphopenia at the beginning of each treatment course were the risk factors for the development of SBI in patients with MM during treatment with bortezomib-containing regimens. Close monitoring for the development of SBI and appropriate treatment should be considered in the patients with risk factors. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Stroke, vascular risk factors and depression

2001 ◽  
Vol 178 (1) ◽  
pp. 23-28 ◽  
Author(s):  
R. Stewart ◽  
M. Prince ◽  
M. Richards ◽  
C. Brayne ◽  
A. Mann
Keyword(s):  
Risk Factors ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Geriatric Depression ◽  
Community Based ◽  
Blood Tests ◽  
Mediating Factor ◽  
The Uk

BackgroundStroke, hypertension and diabetes are common in older Caribbean-born populations in the UK who may be at risk of depression secondary to vascular disease.AimsWe examined the association between stroke, vascular risk factors and depression in a community-based Caribbean-born population aged 55–75 years.MethodVascular risk factors were identified by interview, examination and blood tests. Depression was categorised using the Geriatric Depression Scale. Disablement was assessed as a potential mediating factor.ResultsPhysical illness and disablement were strongly associated with depression, independent of disablement. Previous stroke was associated with depression, independent of disablement. No vascular risk factors were associated with depression.ConclusionsThe risk of depression associated with stroke was not explained by disablement. However, the hypothesis that vascular risk factors are important in the genesis of depression was not supported.

scholarly journals Association between Sedentary Behaviour and Physical, Cognitive, and Psychosocial Status among Older Adults in Assisted Living

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Pet-Ming Leung ◽  
Andreas Ejupi ◽  
Kimberley S. van Schooten ◽  
Omar Aziz ◽  
Fabio Feldman ◽  
...  
Keyword(s):  
Older Adults ◽  
Sedentary Behaviour ◽  
Assisted Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Timed Up And Go ◽  
Psychosocial Status ◽  
Activity Monitors ◽  
Fall Efficacy Scale

Objective. Identification of the factors that influence sedentary behaviour in older adults is important for the design of appropriate intervention strategies. In this study, we determined the prevalence of sedentary behaviour and its association with physical, cognitive, and psychosocial status among older adults residing in Assisted Living (AL). Methods. Participants (n=114, mean age = 86.7) from AL sites in British Columbia wore waist-mounted activity monitors for 7 consecutive days, after being assessed with the Timed Up and Go (TUG), Montreal Cognitive Assessment (MoCA), Short Geriatric Depression Scale (GDS), and Modified Fall Efficacy Scale (MFES). Results. On average, participants spent 87% of their waking hours in sedentary behaviour, which accumulated in 52 bouts per day with each bout lasting an average of 13 minutes. Increased sedentary behaviour associated significantly with scores on the TUG (r=0.373, p<0.001) and MFES (r=-0.261, p=0.005), but not with the MoCA or GDS. Sedentary behaviour also associated with male gender, use of mobility aid, and multiple regression with increased age. Conclusion. We found that sedentary behaviour among older adults in AL associated with TUG scores and falls-related self-efficacy, which are modifiable targets for interventions to decrease sedentary behaviour in this population.

scholarly journals Risk factors for depression in residents of gerontology center in Sarajevo

2015 ◽  
Vol 5 (1) ◽  
pp. 19-24
Author(s):  
Jasmina Mahmutovic ◽  
Aida Rudić ◽  
Arzija Pašalić ◽  
Fatima Jusupović ◽  
Suada Branković ◽  
...  
Keyword(s):  
Risk Factors ◽  
Marital Status ◽  
Sleep Disturbances ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Geriatric Depression ◽  
Cross Sectional ◽  
Younger Age ◽  
Common Risk Factors

Introduction: Depression is the most common mental problem in elderly and is often under-recognized or is inadequately treated, thus significantly affecting the quality of life of elderly people. The reasons for the occurrence of depression in the elderly are multiple. The most common are neurobiological and psychosocial risk factors as well as physical illness. The aim of this study is to determine the presence of the most common risk factors related to the degree of depression, determined by the geriatric depression scale.Methods: This is cross-sectional, descriptive and analytical study undertaken on the sample of 150 psychologically and physically capable residents of the "The Gerontology Center" in Sarajevo older than 65 years. The following instruments were used for research: the Geriatric Depression Scale (GDS) and the modified questionnaire on risk factors important in the depression development.Results: Women are more depressed than men (p<0.01). Depression severity increases with age (p=0.008). The marital status of respondents was significant factor affecting the GDS scores (p=0.009). GDS score and education are weakly correlated (p=0.07) and more educated are less depressed. Also, independently mobile elderly are less depressed (p<0.0005). GDS scores and presence of depression in younger age are dependent (p=0.004). Depression and subjective sleep disturbances are dependent (p=0.002).Conclusion: The most common risk factors for depression in elderly are gender, age, marital status, history of depression in younger age and mobility.

scholarly journals Current Trends of Geriatric Depression at an Indian Tertiary Care Center

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Akash Rajender ◽  
Krishna Kanwal ◽  
Gaurav R
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Treatment Compliance ◽  
Elderly Subjects ◽  
Geriatric Depression ◽  
Prevalence Of Depression ◽  
Associated Risk Factors

Background: Aging is a progressive process beginning with life & ending with death. There is a massive growth in elderly population & age associated diseases. Depression is frequently associated with aging, associated comorbidities & treatment compliance in this fragile age group. Aims & Objective: To study prevalence of depression in elderly using Geriatric Depression Scale (GDS) and its associated risk factors. Method: Three hundred elderly (≥60 years) patients were assessed at Mahatma Gandhi Medical College & Hospital, Jaipur in an observational, cross sectional study using Geriatric Depression Scale (GDS). Correlation with associated risk factors were evaluated. Statistical analysis was done using SPSS version 12.0. Results: Prevalence of depression was 29.3% of which 62 (20.67%) were mildly depressed and 26 (8.67%) were severely depressed. Depression was significantly higher in elderly subjects with comorbid chronic disease (p 0.0001), inadequate sleep (p 0.001), absent social participation (p 0.002) and in those who did not engage themselves in day time work or hobbies (p 0.0002). Conclusions: Depression is common in elderly, its undiagnosed & overlooked. Prevention of risk factors & early diagnosis may significantly reduce morbidity, mortality & improve quality of life.

scholarly journals Análise multifatorial do perfil de idosos ativos com história de quedas

2012 ◽  
Vol 15 (4) ◽  
pp. 693-706 ◽  
Author(s):  
Fernanda Bueno D´Elboux Couto ◽  
Monica Rodrigues Perracini
Keyword(s):  
Functional Assessment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Timed Up And Go ◽  
State Examination ◽  
Assessment Questionnaire ◽  
Functional Assessment Questionnaire

OBJETIVO: Explorar o relacionamento entre variáveis sociodemográficas, clínicas, funcionais e psico-cognitivas em idosos participantes de grupo de convivência, residentes na comunidade, e identificar a associação entre a interação dessas variáveis e quedas e quedas recorrentes. MÉTODO: Estudo transversal, exploratório com 150 idosos, de ambos os sexos, participantes de um grupo de terceira idade no município de Itu, São Paulo. Utilizou-se uma entrevista semiestruturada contendo características sociodemográficas, de saúde física, físico-funcionais (Brazilian OARS Multidimensional Functional Assessment Questionnaire - BOMFAQ e Timed up and go test - TUG), de saúde mental (Geriatric Depression Scale - GDS-15 e Mini Mental State Examination - MMSE). O nível de atividade física foi determinado por questões sobre frequência e duração das atividades físicas. A variável desfecho utilizada foi o número de quedas no último ano. Foi conduzida uma análise de cluster para se identificar perfis de grupos formados pela distribuição da variabilidade dos dados em cada bloco de variáveis: sociodemográficas, desempenho físico-funcional, saúde física e mental. Procedeu-se a análise de regressão uni e multivariada com quedas únicas e quedas recorrentes. RESULTADOS: A idade média dos participantes foi de 71,9 (±5,6) anos. A prevalência de quedas foi de 38,7%. A análise univariada revelou uma associação independente entre o cluster saúde mental (sem sintomas depressivos e com declínio cognitivo) e quedas recorrentes (OR=2,73 IC 95% 1,04-7,22 p=0,042), porém esta associação não foi significativa na análise multivariada (p=0,082). CONCLUSÃO: Não foi possível identificar um perfil de caidores e caidores recorrentes em idosos ativos. Mas nossos achados sugerem que, em idosos ativos com história de quedas, uma avaliação geriátrica abrangente com ênfase na função cognitiva seja considerada.

scholarly journals AVALIAÇÃO FUNCIONAL DE IDOSOS INSTITUCIONALIZADOS E NÃO INSTITUCIONALIZADOS INDEPENDENTES PARA A MARCHA

2016 ◽  
Vol 21 (2) ◽  
Author(s):  
Natalia Camargo Rodrigues ◽  
Patricia Molnar ◽  
Daniela Cristina Carvalho De Abreu
Keyword(s):  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Timed Up And Go ◽  
Mobility Assessment ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

O comprometimento do desempenho funcional observado durante o processo de envelhecimento, associado às demandas socioeconômicas, são motivos que levam à institucionalização de idosos. Entretanto, a institucionalização geralmente acarreta em maior declínio funcional, mesmo em idosos com preservação da independência. Assim, entender melhor o impacto deste contexto ambiental sobre a funcionalidade é importante para auxiliar nas estratégias necessárias para a manutenção do desempenho funcional de idosos. O objetivo do estudo foi comparar o desempenho funcional de idosos independentes para a marcha entre moradores ou não de Instituição de Longa permanência (ILP). Participaram do estudo vinte idosos da comunidade e vinte nove idosos institucionalizados, de ambos os sexos, sem declínio cognitivo. O desempenho funcional foi avaliado pela Escala de Equilíbrio Funcional de Berg, Dynamic Gait Index, Performance-Oriented Mobility Assessment of Gait and Balance e Timed Up and Go e a depressão foi avaliada pelo Geriatric Depression Scale. Os resultados apontaram que os idosos institucionalizados apresentaram maior comprometimento da mobilidade, equilíbrio e marcha em comparação com os idosos da comunidade, o qual pode ser explicado pelo contexto social em que estão inseridos. 

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