ABSTRACT
Medical conditions and dependency levels of the elderly in the Lebanese long-term care institutions have not been described. This may undermine care commissioning and development to institutionalized elderly. Data to inform policy and practice are needed.
Objective: To identify clinical diagnoses and dependency levels among elderly residents in long-term care institutions in Lebanon
Methods: Cross-sectional survey of long-term care institutions throughout Lebanon as identified by the Ministry of Social Affairs
Results: Thirty-one out of 42 long term care institutions have been included in this survey. Among them, 1371 elderly subjects were included in the analysis ; 75.6% were over the age of 75, and female represented 67%. Medical morbidities and associated disabilities have driven admission in 70.5% of residents ; 45.6% of residents reported dementia, stroke or other neurodegenerative disease. Overall, 60% of residents required locomotor assistance
Conclusions: Elderly residents in long-term care institutions are predominantly females, with mental and/or locomotor disabilities resulting from neurological and arthritic conditions. Targeting healthcare for such health conditions remains a challenge for the institutions
ABSTRACT
Background: With the anticipated increase in the number of elderly people in Lebanon, it is important to develop services tailored to their specific needs. The Identification of Seniors At Risk [ISAR] tool identifies, in emergency setting, frail elderly people at risk of adverse outcomes, who are more likely to benefit from a geriatric approach
Objectives: i] Assess the geriatric profile according to ISAR score ; ii] correlate the score to outcomes two months after Emergency Department [ED] visit
Methods: A two month prospective study : at the ED of Hotel-Dieu de France Hospital, we interviewed 273 people aged 70 years and older [or their caregiver] using the ISAR tool. Telephone follow-up was done two months later
Results : The prevalence of subjects with ISAR score >/= 2 and thus likely to benefit from the establishment of a geriatric service is 70.7% [95% CI : 64.9-76.0]. Elderly patients admitted to ED with ISAR score >/= 2 are more likely to be hospitalized [51.6%] than subjects of the same age and sex with ISAR score < 2 [36.9%] [p = 0.034]. After two months of follow-up, the risk of hospital readmission and the risk of death was significantly associated with the ISAR score [p = 0.0005]
Conclusion: The percentage of elderly people likely to benefit from specialized geriatric care network upon admission to the ED of a university hospital is significantly high [70.7% [95% CI: 64.9-76 .0]]
ABSTRACT
Aim of the study: The aim of this study was to compare geometric indices of hip bone strength in overweight and control elderly men
Methods and results: This study included 16 over- weight [Body mass index [BMI] > 25 kg/m2] elderly men [aged 65-84 years] and 38 age-matched controls [BMI < 25 kg/m2]. Body composition and bone miner- al density [BMD] were assessed by dual-energy X-ray absorptiometry [DXA]. To evaluate hip bone geometry, DXA scans were analyzed at the femoral neck, the intertrochanteric region, and the femoral shaft by the Hip Structure Analysis [HSA] program. Cross sectional area [CSA], an index of axial compression strength, section modulus [Z], an index of bending strength, cross sectional moment of inertia [CSMI], an index of structural rigidity, cortical thickness [CT] and buckling ratio [BR] were measured from bone mass profiles. Lean mass, body weight, fat mass and BMI were higher in overweight men compared to controls [p < 0.001]. CSA and Z were higher in overweight subjects compared to controls [p < 0.05] at the three regions [femoral neck, intertrochanteric and femoral shaft]. After adjustment for age, CSA and Z of the intertrochanteric region and the femoral shaft remained significantly higher in overweight men compared to controls [p < 0.05]. After adjustment for either body weight, BMI or lean mass, there were no differences between the two groups [overweight and controls] regarding the HSA variables [CSA, CSMI, Z, CT and BR] of the three regions
Conclusion: This study suggests that overweight elderly men have greater indices of bone axial and bending strength in comparison to controls at the intertrochanteric and the femoral shaft
ABSTRACT
The aim of this study was to determine the relative importance of lean mass and fat mass on bone mineral density [BMD] in a group of Lebanese elderly men. Seventy Lebanese men [aged 65-84 years] participated in this study. Body weight and height were measured and body mass index [BMI] was calculated. Body composition [lean mass, fat mass and fat mass percentage] was assessed by dual-energy X-ray absorptiometry [DXA]. Bone mineral content [BMC] of whole body [WB] and BMD of WB, total hip [TH], femoral neck [FN], ultra distal [UD] radius and 1/3 radius were measured by DXA. The ratios WB BMC/height and WB BMD/height were calculated. Fat mass and lean mass were found to be positively correlated to WB BMC, WB BMC/height, and to WB, TH, FN, UD radius and 1/3 radius BMD. After controlling for age and height, fat mass was more strongly correlated to TH BMD and FN BMD than lean mass while lean mass was more strongly correlated to WB BMC, WB BMD, UD radius BMD and 1/3 radius BMD than fat mass. This study suggests that, in elderly men, fat mass is a stronger determinant of TH and FN BMD than lean mass while lean mass is a stronger determinant of WB BMC, WB BMD, UD radius BMD and 1/3 radius BMD than fat mass
ABSTRACT
To compare bone mineral content [BMC] and bone mineral density [BMD] in a group of Lebanese girls from Beirut and French girls from Orlans. This study included 26 French adolescent girls [15.3 +/- 0.7 years old] and 24 maturationmatched [15.4 +/- 1.1 years old] Lebanese adolescent girls. BMC, BMD at the whole body [WB] and body composition [lean mass and fat mass] were assessed by dual-energy X-ray absorptiometry [DXA]. Calculations of the bone mineral apparent density [BMAD] and the ratio BMC/height were completed for the WB. Weight and height were similar in the two groups. Lean mass was higher in French girls compared to Lebanese girls [p < 0.05]. In the whole population, lean mass was a positive determinant of BMC and BMD. French girls displayed higher values of BMC, BMD, BMC/height and BMAD than Lebanese girls [p < 0.05]. Finally, BMC and BMD remained higher in French girls in comparison to Lebanese girls even after adjusting for lean mass. In this study group, Lebanese girls have lower BMC and BMD in comparison to French girls
ABSTRACT
The aim of the study is to identify risk factors that can worsen the disability in chronic hemodialysis patients. A transversal study was conducted on a total of 210 patients. Data was collected using a 42-item questionnaire, and univariate and multivariate statistical analyses were conducted. Univariate analysis reveals that male sex, advanced age, small stature, low weight, unemployment, lifestyle, lack of sport, hypertension or diabetes, co-morbid conditions, polysulfane filter, time on dialysis, diffuse and chronic pain with high analog visual score are all aggravating disability. Multivariate study confirms advanced age, male sex, hemiplegia, cardiac failure and high analog visual scale as factors aggravating handicap in hemodialysis patients. Modifiable and non modifiable factors can be identified in the disability of dialysis patients. The approach for such patients should be targeted and multifactorial with emphasis on the role of physical rehabilitation and exercises
Subject(s)
Humans , Male , Female , Kidney Failure, Chronic , Risk Factors , Disability EvaluationABSTRACT
A study of the spondylarthropathies, their recent diagnostic criteria and the prevalence of HLA B27 in these affections in Lebanon will soon be started. Experts will have to include patients, prospectively, and to classify them as having or not a spondylarthropathy, according solely to their clinical judgement. The decision of the expert is of major importance in including patients in the study. We performed a clinical evaluation of inter-observer variability to select experts according to a significant concordance in the clinical diagnosis of different rheumatic diseases, especially spondylarthropathies. Results of the evaluation are presented and discussed