mahtab alizadeh khoei

Frailty is accompanied by serious health complications in the elderly, especially during hospitalization. Visual scales have been designed for quick and easy evaluation of frailty in different cultures and settings. Therefore, this study aimed to define the accuracy of the Pictorial Fit Frail Scale (PFFS) for frailty screening in the hospitalized elderly in Iran.

This cross-sectional study was conducted on 304 hospitalized participants, aged 65-85 years old admitted at Ziaeian Hospital (Tehran) were enrolled through the inclusion criteria from August to December 2019. All participants were evaluated based on the Minimum Data Set-Home Care, the Pictorial Fit Frail Scale, and the Quality-of-Life instrument, through face-to-face interviews by a trained nurse at the admission time. Spearman’s correlation coefficient, and ROC analysis were performed using SPSS at p<0.05.

The highest correlation was obtained by Frailty Index (FI) and PFFS (0.770). FI had a negative correlation with QoL (-0.48). The optimal cut-points for PFFS according to FI ≤ 0.08 (robust vs. pre-frail) was obtained 0.10 with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00% and the best cut-point for PFFS based on FI ≥ 0.25 (pre-frail vs. frail) was obtained 0.29 with sensitivity and specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00%.

It seems the Pictorial Fit-Frail Scale (PFFS) is a reliable scale with a high level of accuracy, and excellent sensitivity and specificity to measure the frailty level in hospitalized elderlies.

In COVID-19 pandemic, underlying diseases such as cardiovascular disease, respiratory illness, liver and kidney disease or malignancies, have a critical prognostic role for these patients. 

Due to the increased risk of mortality in patients with established or new-onset comorbidities, we decided to conduct a study to further investigate the possible comorbidities and treatment recommendations of COVID-19.

All articles published by March 25, 2020 on the new coronavirus infection were reviewed and for cutaneous manifestation as a new emerging concern, by April 25, 2020. ScienceDirect, Google scholar, Scopus, PubMed databases were searched and keywords such as "COVID-19", "2019-nCoV", "Coronavirus2019", "SARS-CoV-2”, and "comorbidity" have been used.

the most important comorbidity in elderly patients with confirmed covid-19 was cardiovascular disease, followed by diabetes and chronic respiratory disease, respectively, and on the other hand, covid-19 itself could cause acute heart, lung, liver, kidney and skin disease. Also the prevalence of underlying diseases in died patients or patients with severe COVID-19 are higher than the others. Considering treatment; Drug interactions and careful drug adjustment based on hepatic and renal metabolism are essential.

The results of this study showed that the mortality rate and ICU admission in people with underlying disease is higher than other people. Also we must pay attention to the possible multi-organ damages and comorbidities, for protection and successful treatment of COVID-19. There are some comorbidities like primary cutaneous manifestations that may have diagnostic or prognostic values in COVID-19 course.

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.

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".

  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.

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.

Validation study of Barthel Index for elderly patients being attended in outpatient and rehabilitation clinics in Iran.

Face‑to‑face interview with 395 out patients geriatric 60+ years was done in a cross‑sectional study. The internal consistency Barthel‑ADL was used to approve reliability. Criterion validity and factor analysis were used to verify validity.

Reliability the Iranian version BI was significant at 0.938. In criterion validity analysis, the high correlation tools included Functional Ambulation Category (FAC) and Foot and Ankle Ability Measure (FAAM‑subscales ADL) at 0.947 and –0.945, respectively. In factor analyses, two domains obtained, the variance of 10 items achieved 69.79%; also, the Item Total Correlation (ITC) of each item was measured.

The Barthel Index shows a good validity and reliability, and recommended to use in the Iranian geriatric outpatients in evaluating physical ability.

Falling is one of the health problems among aged population. Elderly living in institutions are at greater risk of falling than those dwellings in the community, due to their health status and environmental conditions. This study was designed and conducted aimed to address the factors affecting falls in Kahrizak Charity Foundation (KCF).

This is a prospective longitudinal study, which 194 of residents of KCF were participating in it with inclusion criteria were selected by Random Cluster sampling. They were enrolled after signing an informed consent. At baseline the data of demographic, lifestyle, past medical history and visual ability were collected by interviewing. The anthropometric measurements were performed as well. Cognitive status data were collected using abbreviated mental test (AMT) questionnaire and mini mental state examination (MMSE), balance status was assessed using the Tinetti mobility test (TMT) and its balance and gait sub- scores, depression was detected using the geriatric depression scale-15 (GDS-15). The participants were monitored for the falls occurrence its complications by daily call with caregivers and filling out the special forms for the recording of the falls occurrence by the head nurse. Data were analyzed using univariate and multivariable Cox-regression models.

The mean age of the participants was76.02 (8.82) years and the mean follow-up days was 754.40±189.26 days. 44 cases of falls were recorded during follow-up (over two years). The fall rate was 22.7 subjects per 100 participants per year. History of stroke, Parkinson's disease, visual loss, taking antidepressants, TMT score and TMT balance sub-score after adjustment (for age, sex, body mass index and survival time) were associated with falls.

The falls among nursing home elderly residents were associated with a history of chronic diseases such as stroke and Parkinson's diseases, visual acuity, use of antidepressants and the TMT and its balance sub score.