RESUMO
Background and Objectives: Altered mental status (AMS) is a challenging diagnosis in elderly patients and has a wide range of etiologies. The aim of this study was to know the clinical and etiological profile in the elderly, so that physicians will be better aware of AMS backgrounds and reducing morbidity and mortality rates among the patients. Materials and Methods: This was a prospective observational study conducted at the emergency department (ED) and medical intensive care unit (MICU) of a tertiary care hospital in South India from November 1, 2019, to October 31, 2020. Patients aged 65 years and older who presented to the ED and MICU with AMS were included in this study. They were evaluated clinically and necessary investigations were done to know the etiologies. Results: Among 100 elderly patients, 64% belonged to young old (age group of 65–74 years), 30% belonged to old (age group of 75–84 years), and 6% belonged to oldest old (>85 years). Sixty?one percent were male and 39% were female. The most common cause for AMS in elderly was primary neurological cause (40%, cerebrovascular accident was most common cause). The other causes were metabolic encephalopathy (29%, hyponatremia being most common) followed by multifactorial causes (24%). Infections and hypertensive encephalopathy were noted in 6% and 1% respectively. The common comorbidities found were hypertension (71%) and type 2 diabetes mellitus (50%), and 28% had diabetes mellitus and hypertension, whereas 25% had multiple comorbidities. Conclusion: The elderly patients who present with AMS must be screened for the above etiologies. This study helps the physicians to have an idea regarding common causes of AMS in elderly patients at presentation, hence appropriate management approach thus helps in reducing morbidity and mortality.
RESUMO
Background: The ageing process is not determined truly by genes and personal characteristics but mainly by his adjustment with the environment he lives. Ageing of a person depends on many factors which influence the course of life like physiological, social, psychological, economic, environmental and cultural factors which in turn affect the quality of life (QoL). Given these findings, quality of life is influenced by the place where a person lives. The objective of the study was to assess and compare the quality of life of elderly living in old age homes and community. Methods: This was a cross sectional, questionnaire based study done on elderly people (>60 years) living in old age home, urban and rural area. The study was carried out for a period of 3 months from April to June 2016 after taking consent from the study participants. WHOQoL-BREF questionnaire was used to assess the quality of life. Results: Elderly females were more than elderly males in rural and old age home. The study participants of all the three places were concentrated in the age group 65-70 years old. The mean scores of physical, psychological and social domains were high in urban elderly people. Most of the study population was illiterate in urban and rural area but in old age home most of them were educated. There was significant difference between the mean scores for psychological and environmental domain (p=0.048 and 0.001 respectively). Conclusions: Participants living in the urban area had higher mean scores in the physical, psychological and social domains as compared to rural area and old age home. The mean score of environmental domain was high in rural area as compared to urban and old age home.